{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:48:14Z","timestamp":1770742094951,"version":"3.49.0"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T00:00:00Z","timestamp":1664928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Large analyses of T4 larynx cancer (LC) have raised concerns that larynx preservation (LP) contributes to reduced survival compared with laryngectomy (LGX). The role of operability has not been previously considered as a confounder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We queried the National Cancer Database for T4M0 LC diagnosed 2004\u20132015. Patients were categorized as undergoing LGX, chemoradiotherapy but operable (LP\u2010operable), and chemoradiotherapy inoperable (LP\u2010inoperable). Overall survival (OS) was estimated by Kaplan\u2013Meier. Cox multivariate analysis (MVA) identified variables associated with OS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 1405 LGX, 164 LP\u2010operable and 1969 LP\u2010inoperable patients. Compared with LGX, MVA demonstrated worse OS among LP\u2010inoperable (HR 1.28 95%CI 1.17\u20131.40, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) but not LP\u2010operable patients (HR 1.12 95%CI 0.91\u20131.39, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.28).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>LP\u2010operable patients did not have significantly worse OS than those undergoing LGX.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27204","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T10:39:05Z","timestamp":1664966345000},"page":"2854-2864","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of operability status on outcomes in patients with <scp>T4<\/scp> larynx cancer undergoing larynx preservation"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5994-7977","authenticated-orcid":false,"given":"Ashley J.","family":"Schlafstein","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Winship Cancer Institute Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1737-7771","authenticated-orcid":false,"given":"Subir","family":"Goyal","sequence":"additional","affiliation":[{"name":"Biostatistics Shared Resource, Winship Cancer Institute Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6205-5969","authenticated-orcid":false,"given":"Arya","family":"Amini","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology City of Hope Comprehensive Cancer Center  Duarte California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1676-5967","authenticated-orcid":false,"given":"Sana D.","family":"Karam","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Colorado school of Medicine  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4972-1477","authenticated-orcid":false,"given":"Nabil F.","family":"Saba","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Winship Cancer Institute Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azeem S.","family":"Kaka","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley 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