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

Language: Spanish
References: 16
Page: 105-109
PDF size: 320.82 Kb.

ABSTRACT

The purpose of conservative surgical treatment of laryngeal cancer is to obtain cancer control with preservation of laryngeal function, and in turn, the preservation of laryngeal function should be understood as the preservation of the patient’s ability to ventilate in the normal way without tracheostomy and without aspiration and maintaining intelligible speech. This objective 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 (SCSL) is the voice conservative surgical technique which offers the best possibility of control in patients with locally advanced laryngeal cancer, and the proper histopathological analysis allows staging and selecting patients eligible for adjuvant therapy, avoiding unnecessary therapies, and allows design of 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 SCSL. The proper communication between the 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 a 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(12):2893-917.

2. SINAIS/SINAVE/DGE/SALUD. Perfil epidemiológico de los tumores malignos en México. 200.8 [Internet] Disponible en: www.sinais.salud.gob.mx.

3. Gallegos-Hernández JF. El cáncer de cabeza y cuello. Factores de riesgo y prevención. Cir Ciruj. 2006;74:187-93.

4. Chu EA, Kim YJ. Laryngeal cancer: Diagnosis and preoperative work-up. Otolaryngol Clin N Am. 2008;41(4):673-95.

5. Agrawal N, Ha PK. Management of early-stage laryngeal cancer. Otolaryngol Clin N Am. 2008;41(4):757-69.

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): 231-8.

8. Tufano R, Stafford E MD. Organ preservation surgery for laryngeal cancer. Otolaryngol Clin N Am. 2008;41(4):741-55.

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

10. Gallegos-Hernández JF, Minauro-Muñoz GG, Arias-Ceballos H, Hernández- Sanjuan M, Flores-Díaz R, Resendiz-Colosia J. [Partial pharyngolaryngectomies for treatment of pharyngolaryngeal cancer]. Cir Cir. 2008;76(3):213-7.

11. Majer EH, Rieder W. [Experiences with cricohioidopexy]. Monatsschr Ohrenheilkd Laryngorhinol. 1972;106(7):389.

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

13. Gallo A, Manciocco V, Tropiano ML, 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(7):620-5.

15. Mantilla-Morales A, Gallegos-Hernández JF, Posada-Sibaja A. [Histopathologic study of the frontolateral laryngectomy specimen: topics of clinical interest]. Cir Ciruj. 2005;73(4):315-8.

16. Buckley JG, MacLennan K. Cancer spread in the larynx: A pathologic basis for conservation surgery. Head and Neck. 2000; 22(3):265-74.