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Current treatment practices for early laryngeal carcinoma.

Publication ,  Journal Article
DiNardo, LJ; Kaylie, DM; Isaacson, J
Published in: Otolaryngol Head Neck Surg
January 1999

OBJECTIVE: Controversy regarding the management of early laryngeal carcinoma persists in the absence of a definitive comparison of treatment modalities. This study examines the basic management practices for early laryngeal cancer among the American Academy of Otolaryngology-Head and Neck Surgery membership with an emphasis on the role of conservation surgery. METHODS: Questionnaires were randomly distributed to 3000 members with 1000 responses. The results were collated and statistically evaluated with multivariable frequency analysis. RESULTS: For operable supraglottic tumors, supraglottic laryngectomy was advocated by 41.6% of those responding. Definitive radiation therapy was suggested by 5.3% of participants and total laryngectomy by 1.4%. Explanation of treatment options with the patient deciding the therapy was selected by 48.3% of responders. For suitable glottic tumors, hemilaryngectomy was recommended by 37.1%, definitive radiation therapy by 8.1%, total laryngectomy by 1.9%, and patient choice by 50.4% of members completing the survey. When patients were left to weigh the treatment options, surgery was much less likely to be chosen than if it was advocated by the physician. Trends were evident according to practice region and setting, but these variables did not correlate strongly with physician recommendations. However, date of residency completion and rating of available radiation oncology services were significant factors. The evaluation of postoperative considerations in laryngeal conservation surgery demonstrated large variability in the definition of a close margin and the perceived need for additional therapy. CONCLUSIONS: The varied practice patterns among the American Academy of Otolaryngology-Head and Neck Surgery membership reflect the lack of a comparative outcome analysis for the treatment of early laryngeal carcinoma. Consequently, the full reliance on patient choice, which is more pronounced among young physicians, and cost considerations may have the greatest impact on the future treatment of this disease.

Duke Scholars

Published In

Otolaryngol Head Neck Surg

DOI

ISSN

0194-5998

Publication Date

January 1999

Volume

120

Issue

1

Start / End Page

30 / 37

Location

England

Related Subject Headings

  • United States
  • Practice Patterns, Physicians'
  • Otorhinolaryngology
  • Laryngectomy
  • Laryngeal Neoplasms
  • Humans
  • Glottis
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Chicago
ICMJE
MLA
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DiNardo, L. J., Kaylie, D. M., & Isaacson, J. (1999). Current treatment practices for early laryngeal carcinoma. Otolaryngol Head Neck Surg, 120(1), 30–37. https://doi.org/10.1016/S0194-5998(99)70366-9
DiNardo, L. J., D. M. Kaylie, and J. Isaacson. “Current treatment practices for early laryngeal carcinoma.Otolaryngol Head Neck Surg 120, no. 1 (January 1999): 30–37. https://doi.org/10.1016/S0194-5998(99)70366-9.
DiNardo LJ, Kaylie DM, Isaacson J. Current treatment practices for early laryngeal carcinoma. Otolaryngol Head Neck Surg. 1999 Jan;120(1):30–7.
DiNardo, L. J., et al. “Current treatment practices for early laryngeal carcinoma.Otolaryngol Head Neck Surg, vol. 120, no. 1, Jan. 1999, pp. 30–37. Pubmed, doi:10.1016/S0194-5998(99)70366-9.
DiNardo LJ, Kaylie DM, Isaacson J. Current treatment practices for early laryngeal carcinoma. Otolaryngol Head Neck Surg. 1999 Jan;120(1):30–37.
Journal cover image

Published In

Otolaryngol Head Neck Surg

DOI

ISSN

0194-5998

Publication Date

January 1999

Volume

120

Issue

1

Start / End Page

30 / 37

Location

England

Related Subject Headings

  • United States
  • Practice Patterns, Physicians'
  • Otorhinolaryngology
  • Laryngectomy
  • Laryngeal Neoplasms
  • Humans
  • Glottis
  • 3202 Clinical sciences
  • 1103 Clinical Sciences