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Gem\u00e4\u00df der neuen S3-Leitlinie nehme der Patient zwar eine h\u00f6here R\u00fcckfallrate in Kauf, habe aber die Salvagechirurgie als kurative Option und insgesamt keinen \u00dcberlebensnachteil. In mehreren gro\u00dfen Datenbankanalysen und Fallserien findet sich f\u00fcr das T4-Larynxkarzinom ein signifikanter \u00dcberlebensnachteil der pRCT gegen\u00fcber der prim\u00e4ren TL von \u00fcber 30\u202f%. Die Erfolgsrate der Salvagelaryngektomie beim T4-Karzinom liegt laut Literatur nur bei 25\u201350\u202f%. Larynxorganerhaltstudien, die zur Empfehlung der pRCT als alternativer Standardtherapie f\u00fchren k\u00f6nnten, sollten 1.)\u00a0T4a-Karzinompatienten innerhalb ihrer T\u2011Kategorie auswerten, 2.)\u00a0getrennt nach Larynx- und Hypopharynxkarzinomen, 3.)\u00a0in aussagekr\u00e4ftiger Kollektivgr\u00f6\u00dfe, 4.)\u00a0mit einem Nachbeobachtungszeitraum von mindestens 5\u00a0Jahren, 5.)\u00a0mit onkologischen und 6.)\u00a0funktionellen Outcome (Dauer von Tracheostoma u.\/o. PEG, Notwendigkeit und Erfolg einer Salvagelaryngektomie). 7.)\u00a0Angabe des Kriteriums, das zur T4-Kategorie f\u00fchrte (Knorpeldurchbruch oder Art der extralaryngealen Ausbreitung), 8.)\u00a0pr\u00e4therapeutische Larynxfunktionalit\u00e4t (Tracheostoma, PEG). Eine Erfassung der genannten klinischen Daten aller T4-pRCT-Patienten in einer prospektiven beobachtenden Kohortenstudie im deutschsprachigen Raum wird vorgeschlagen. Bei Ablehnung der TL beim T4a-Karzinom sollte in ausf\u00fchrlichen einf\u00fchlsamen, aber instruktiven Gespr\u00e4chen unterschieden werden zwischen einer prim\u00e4ren spontanen Abneigung und der differenziert abgewogenen, definitiven Ablehnung. Nicht nur der onkologische, sondern auch der funktionell zu erwartende Outcome sollte in den Entscheidungsprozess einbezogen werden.<\/jats:p>","DOI":"10.1007\/s00106-022-01180-y","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T12:03:58Z","timestamp":1653393838000},"page":"595-600","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Larynxorganerhalt bis zum T4\u2011Larynxkarzinom?"],"prefix":"10.1007","volume":"70","author":[{"given":"Gerhard","family":"Dyckhoff","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf","family":"Warta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christel","family":"Herold-Mende","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter K.","family":"Plinkert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heribert","family":"Ramroth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,24]]},"reference":[{"key":"1180_CR1","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1097\/COC.0000000000000550","volume":"42","author":"JE Bates","year":"2019","unstructured":"Bates\u00a0JE, Amdur\u00a0RJ, Morris\u00a0CM et al (2019) Curative-dose chemoradiotherapy versus total laryngectomy for stage T3-T4 squamous cell carcinoma of the larynx: an \u201capples-to-apples\u201d analysis of the national cancer database. 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