Title:

Prognostic importance of the location of carcinoma within the larynx

Author:

Kurzyński, Marian

Subject:

laryngeal carcinoma ; supraglottic level of the larynx ; marginal location ; horizontal surgery ; radiotherapy

Abstract:

Laryngeal carcinoma is one of the most common malignancies. In Poland, in the early 1990s, it ranked fifth in terms of incidence of malignant neoplasms among males, and seventh among the causes of death of malignant neoplasms. Since about 25 years, there have been a systematic increase in the rate of incidence of carcinomas with primary location at the supraglottic level. Shifting the primary location from the inner regions of the larynx towards the marginal parts, particularly the upper margin, implies dangerous consequences regarding the prognosis on particular patient’s future health. In view of the practical and clinical importance, several significant anatomical regions are distinguished in order to provide reference system for the analysis of the therapy applied. The predicted manner of tumor development and spreading indicates the possibility of applying surgical management while retaining its oncological radicalness. The decision on the choice of treatment method in the laryngeal cancer depends upon a number of factors related to the patient and the characteristics of the tumour itself. The principal objectives include curing from cancer and retaining the phonatory function of the larynx. The treatment of patients suffering from laryngeal carcinoma includes surgery, radiotherapy and chemotherapy, either as separate or combined methods of therapy. The objective of the presented research is to put forward more precise indications and therapeutic procedures in the management of supraglottic region of the larynx in cases of cancers with so-called marginal locations. The studies and retrospective analysis of cases involved 129 patients of the Department of Otolaryngology of the University Hospital, Jagiellonian University Collegium Medicum. All patients in the study underwent surgical treatment in the form of either horizontal or subtotal laryngectomy for epiglottis carcinomas with supraglottic location. The patients were divided into two opposite groups with the extent of the tumor in the supraglottic level of the larynx as a criterion of allocation to either group. Retrospective studies were based on medical records of the treatment and the data subjected to statistical analysis. The evaluation of the significance of so-called marginal location of the cancer at the supraglottic level to the future condition of the patient constitutes an original approach. Author’s own research were included in wider summary reports of the Department of Otolaryngology of the University Hospital. The results of more thorough analysis the records pertaining to these patients indicated worse outcomes than in surgically treated patients with cancer supraglottic locations but other than in the marginal zone. The results of the studies prompt the author to deem the fundamental canons of surgical treatment of the laryngeal carcinoma of the marginal location applied to date to be right and not in need of modifications. The primary laryngeal carcinoma in marginal locations does not show any different features of biology compared with the carcinomas of other locations in the supraglottic level of the larynx. The indications to perform extensive resection of the supraglottic level of the larynx should be broadened.

Level of degree:

2 - studia doktoranckie

Degree discipline:

onkologia ; otorynolaryngologia

Degree grantor:

Wydział Lekarski

Promoter:

Eugeniusz Olszewski

Date:

2008

Date issued:

2008

Type:

Praca doktorska

Format:

application/pdf

Call number:

ZB-108269

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Access rights:

nieograniczony

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

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