García-Sánchez M, Romero-Durán E, Mantilla-Morales A, Gallegos-Hernández JF

Language: Spanish
References: 16
Page: 126-130
PDF size: 214.15 Kb.

ABSTRACT

The aim of the conservative surgical treatment of laryngeal cancer is to obtain cancer control while preserving laryngeal function. The preservation of laryngeal function should be understood as the preservation of the patient’s ability to ventilate normally without tracheostomy or aspiration, keeping speech intelligible. This purpose is achieved by maintaining a balance between two fundamental aspects: proper patient selection (based on tumor extension and preoperative laryngeal function) and an adequate histopathological analysis of the surgical specimen. Supracricoid subtotal laryngectomy is the voice conservative surgical technique which offers the best possibility of control in patients with locally advanced laryngeal cancer; the proper histopathological analysis allows staging and selecting patients eligible for adjuvant therapy, avoiding unnecessary therapies, and allows to design a monitoring and surveillance program based on risk factors. The aim of this manuscript is to highlight key points in the histopathological evaluation of the surgical specimen of supracricoid subtotal laryngectomy. The proper communication between surgeon and pathologist, offering complete information on preoperative clinical evaluation, and the knowledge of the key points in the evaluation of the surgical specimen (sites of tumor leakage and surgical resection margins) are fundamental parameters to achieve proper histopathologic evaluation of the surgical specimen.

REFERENCES

1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer 2008: GLOBOCAN 2008. Int J Cancer. 2010; 127: 2893-2917.

2. SINAIS/SINAVE/DGE/SALUD. Perfil epidemiológico de los tumores malignos en México. [Internet]. Disponible en: www.sinais.salud.gob.mx. 2008.

3. Gallegos-Hernández JF. El cáncer de cabeza y cuello. Factores de riesgo y prevención. Cir Ciruj. 2006; 74: 187-193.

4. Eugene A. Chu, Young J. Kim MD. Laryngeal cancer: Diagnosis and preoperative work-up. Otolaryngol Clin N Am. 2008; 41: 673-695.

5. Agrawal N, Patrick K. Ha MD. Management of early-stage laryngeal cancer. Otolaryngol Clin N Am. 2008; 41: 757-769.

6. Gallegos-Hernández JF. Cirugía parcial de laringe, técnica y resultados. Cir Ciruj. 2010; 78: 351-455.

7. Rodrigo JP, Coca-Pelaz A, Suárez C. The current role of partial surgery as a strategy for functional preservation in laryngeal carcinoma. Acta Otorrinolaringol Esp. 2011; 62 (3): 231-238.

8. Tufano R, Stafford E MD. Organ preservation surgery for laryngeal cancer. Otolaryngol Clin N Am. 2008; 41: 741-755.

9. Chawla S, Carney AS. Organ preservation surgery for laryngeal cancer. Head & Neck Oncology. 2009; 1: 12.

10. Gallegos-Hernández JF, Minauro-Muñoz GG, Arias-Ceballos H, Hernández-Sanjuan M, Flores-Díaz R, Resendiz-Colosia J. Faringo-laringectomías parciales para el tratamiento del cáncer faringolaríngeo. Cir Cir. 2008; 76: 213-217.

11. Majer EH, Rieder W. Experiences with cricohioidopexy. Monatsschr Ohrenheilkd Laryngorhinol. 1972; 106: 389.

12. Piquet JJ. Functional laryngectomy (cricohyioidopexy). Clin Otolaryngol Allied Sci. 1976; 1: 7-16.

13. Gallo A, Manciocco V, Tropiano ML, Simonelli M, Marvaso V, D’Arcangelo E et al. Prognostic value of resection margins in supracricoid laryngectomy. The Laringoscope. 2004; 114 (4): 616-621.

14. Gallo A, Manciocco V, Simonelli M, Pagliuca G, D’Arcangelo E, de Vincentiis M. Supracricoid partial laryngectomy in the treatment of laryngeal cancer: univariate and multivariate analysis of prognostic factors. Arch Otolaryngol Head Neck Surg. 2005; 131: 620-625.

15. Mantilla-Morales A. Gallegos-Hernández JF. Estudio histopatológico en la pieza de laringectomía frontolateral. Puntos de interés clínico. Cir Ciruj. 2005; 73: 315-318.

16. Buckley JG, Mac Lennan K. Cancer spread in the larynx: A pathologic basis for conservation surgery. Head and Neck. 2000; 22 (3): 265-274.