Selected laryngeal squamous cell carcinomas with laryngeal mobility impairment are suitable for curative larynx-preservation treatment
Bibliographic record
Abstract
INTRODUCTION: Mobility impairment defines a specific subset of laryngeal squamous cell carcinoma (LSCC), with implications for prognosis and treatment. While total laryngectomy (TL) is often considered for mobility-impairing LSCC (MI-LSCC), the role of organ-preserving strategies such as open partial horizontal laryngectomy (OPHL) and non-surgical treatments (NST) remains debated. This study aims to evaluate the outcomes of different treatment strategies for patients with MI-LSCC. MATERIALS AND METHODS: A retrospective analysis was conducted on 406 MI-LSCC patients using data from the ARYFIX collaborative study. Patients with subglottic tumors or those receiving unimodal radiotherapy (RT) were excluded. Treatment modalities included TL, TL with adjuvant (chemo)radiotherapy ((C)RT), OPHL, OPHL with adjuvant (C)RT, and definitive NST. Survival outcomes, including overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS), and laryngo-esophageal dysfunction-free survival (LEDFS), were assessed. Population clustering and propensity score matching (PSM) were used to balance covariates across treatment groups. RESULTS: The 5-year rates of OS and DSS were 72.0% and 86.2%, respectively. PSM-adjusted analysis indicated that OPHL was associated with the best outcomes. TL with adjuvant (C)RT provided favorable oncologic control, while NST was associated with higher cancer-unrelated mortality and reduced locoregional control. However, NST yielded the best outcomes in patients with N2-3 MI-LSCC. OPHL followed by (C)RT was associated with inferior DSS and unfavorable LEDFS. CONCLUSION: In MI-LSCC, OPHL offers satisfactory oncologic and functional outcomes, provided that patient selection is performed carefully. NST, although associated with poorer locoregional control, optimizes outcomes in MI-LSCC with high nodal burden. Treatment for MI-LSCC should be individualized, considering tumor extension, patient fitness, and institutional expertise.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".