Page 57 - Portuguese Journal - SPORL - Vol 61. Nº2

Figure 1 Table 1
Annual distribution of surgeries Characteristics of the patients undergoing total
(total laryngectomies) laryngectomy
Variable Frequency %
Sex
Male 52 96,3%
Female 2 3,7%
Location of the primary tumor
Supraglottic 32 59,3%
Glottic 13 24,1%
Hypopharyngeal 9 16,6%
Clinical stage (cT cN)
cT2 cN0 2 3,7%
and 23 of these also received chemotherapy cT2 cN1 2 3,7%
(CT). The patients with surgical margins < 5 mm cT3 cN0 17 31,5%
3,7%
underwent CTRT more often (p<0.001) and also cT3 cN1 7 2 12,9%
cT3 cN2
had a higher rate of relapse (p=0.009) (Table cT3 cN3 3 5,6%
1). PET-CT, positron emission tomography- cT4 cN0 7 12,9%
computed tomography. cT4 cN1 4 7,4%
There was a discrepancy between the final cT4 cN2 10 18,6%
clinical and pathological staging in 17 cases Pathological stage (pT pN)
(31.5%), which was not related to the tumor pT1 pN0 2 3,7%
location (supraglottic [p=0.522], glottic pT1 pN1 1 1,9%
[p=0.303], or hypopharyngeal [p=0.703]). pT2 pN0 3 5,6%
2
3,7%
Downstaging of the overall stage occurred pT2 pN3 11 20,3%
pT3 pN0
in 10 cases, most often (6/10 patients) from pT3 pN1 1 1,9%
stage IV to stage III, whereas upstaging pT3 pN2 9 16,7%
occurred in seven cases (from stage III to pT3 pN3 4 7,4%
stage IV in 6/7 patients). The change in final pT4 pN0 7 12,9%
staging (downstaging and upstaging) was pT4 pN1 2 3,7%
not associated with an increase in the rate pT4 pN2 6 11,1%
of relapse (p=0.911 and p=0.859, respectively) pT4 pN3 6 11,1%
or death (p=0.805 and p=0.775, respectively). Overall stage (pathological) 2 4,3%
I
There was a discordance regarding the T II 3 5,6%
category in 35.1% (19/54) cases, with it being III 13 24,1%
more often clinically overestimated, which IV 36 66%
was reflected in a higher percentage of cases PET-CT
of downstaging (68.4%; 13/19 cases) than of Yes 29 53,7%
upstaging (31.6%; 6/19 cases). Discordance No 25 46,3%
regarding the N category occurred in 44% Surgical margin
(24/54) cases and it was more often clinically <5mm 8 14,8%
underestimated, resulting into a higher >5mm 46 85,2%
Complementary treatment
38
70,4%
percentage of cases of upstaging (75%; 18/24 Radiotherapy 15 39,5%
cases) than of downstaging (25%; 6/24 cases) Chemotherapy + Radiotherapy 23 60,5%
(Table 2). Relapse
With regard to the T category, there was Yes 17 31,5%
greater clinico-pathological agreement for the No 37 68,5%
invasion of the preepiglottic space (p=0.017), Death
anterior commissure (p=0.003), cricoid Yes 18 33,3%
No 36 66,7%

Volume 61 . Nº2 . June 2023 199