Those are just two of the questions addressed in this year’s two Mosher Award-winning theses, which were presented as part of the Triological Society‘s program here at the 2006 Combined Otolaryngology Spring Meeting (COSM).
Laryngeal Cancer: Demographics, Patterns of Care, and Survival Rates
The last large study of laryngeal cancer in the United States was published in 1997 and compared management in the early 1980s to management in the early 1990s. Over that same time period, data show that the use of irradiation increased and use of surgery as a single treatment modality decreased. A major impetus for that change arose from Veterans Administration Cancer Study Group findings, first published in 1991, that suggested the treatment of advanced laryngeal cancer with induction chemotherapy followed by radiation allows some patients to preserve their larynx without sacrificing cure rates.
This led some researchers to relate that total laryngectomy was no longer useful in the initial treatment of laryngeal cancer and prompted others to identify that, even if survivals are only equivalent, organ-preservation approaches should be the treatment of choice, said thesis author Henry T. Hoffman, MD, Professor of Otolaryngology-Head and Neck Surgery at the University of Iowa in Iowa City. However, this raises the question as to whether organ preservation approaches provide equivalent survival when offered outside of a controlled study.