{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T23:33:03Z","timestamp":1768519983160,"version":"3.49.0"},"reference-count":18,"publisher":"FapUNIFESP (SciELO)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>Summary Introduction: Since the beginning of the 1990s, non-surgical radiochemotherapy treatment has become popular with the prospect of maintaining oncological results and preserving the organ in patients with advanced squamous cell carcinoma of the larynx and hypopharynx. However, subsequent studies demonstrated increased recurrence and mortality after the non-surgical treatment became popular. Objective: To compare the oncological results of surgical and non-surgical treatments of patients with larynx and hypopharynx cancer and to evaluate the variables associated with disease recurrence. Method: This is a retrospective cohort study of 134 patients undergoing surgical (total or partial laryngectomy) or non-surgical (isolated radiotherapy, chemotherapy or induction chemotherapy followed by radiotherapy and chemotherapy) treatment, with 62 patients in the surgical group and 72 in the non-surgical group. Results: Disease-free survival rates were higher in the surgical group (81.7% vs. 62.2%; p=0.028), especially in III\/IV stages (p=0.018), locally advanced tumors T3 and T4a (p=0.021) and N0\/N1 cases (p=0.005). The presence of cervical lymph nodes, especially N2\/N3, was considered a risk factor for disease recurrence in both groups (HR=11.82; 95CI 3.42-40.88; p&lt;0.0001). Patients not undergoing surgical treatment were 3.8 times more likely to develop recurrence (HR=3.76; 95CI 1.27-11.14; p=0.039). Conclusion: Patients with larynx or hypopharynx cancer non-surgically treated had a poorer disease-free survival, especially in cases with locally advanced tumors (T3 and T4a) and in which the neck was only slightly affected (N0\/N1).<\/jats:p>","DOI":"10.1590\/1806-9282.63.12.1082","type":"journal-article","created":{"date-parts":[[2018,2,24]],"date-time":"2018-02-24T23:10:23Z","timestamp":1519513823000},"page":"1082-1089","source":"Crossref","is-referenced-by-count":10,"title":["Oncological results of surgical treatment versus organ-function preservation in larynx and hypopharynx c\u00e2ncer"],"prefix":"10.1590","volume":"63","author":[{"given":"Oscar Israel Jaramillo","family":"Calvas","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Marin","family":"Ramos","sequence":"additional","affiliation":[{"name":"Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo, Brazil; Universidade de S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leandro Luongo","family":"Matos","sequence":"additional","affiliation":[{"name":"Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo, Brazil; Universidade de S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco Aur\u00e9lio Vamondes","family":"Kulcsar","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brazil; Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rog\u00e9rio Aparecido","family":"Dedivitis","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lenine Garcia","family":"Brand\u00e3o","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio Roberto","family":"Cernea","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2017,12]]},"reference":[{"issue":"1","key":"ref1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/hed.21294","article-title":"Reexamining the treatment of advanced laryngeal cancer","volume":"32","author":"Olsen KD","year":"2010","journal-title":"Head Neck"},{"issue":"24","key":"ref2","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1056\/NEJM199106133242402","article-title":"Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer","volume":"324","year":"1991","journal-title":"N Engl J Med"},{"issue":"1","key":"ref3","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S0360-3016(00)00415-6","article-title":"Comparing treatment outcomes of radiotherapy and surgery in locally advanced carcinoma of the larynx a comparison limited to patients eligible for surgery","volume":"47","author":"MacKenzie RG","year":"2000","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"22","key":"ref4","doi-asserted-by":"crossref","first-page":"2091","DOI":"10.1056\/NEJMoa031317","article-title":"Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer","volume":"349","author":"Forastiere AA","year":"2003","journal-title":"N Engl J Med"},{"issue":"7","key":"ref5","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1200\/JCO.2012.43.6097","article-title":"Long-term results of RTOG 91-11 a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer","volume":"31","author":"Forastiere AA","year":"2013","journal-title":"J Clin Oncol"},{"issue":"4","key":"ref6","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1200\/JCO.2005.04.1954","article-title":"Induction chemotherapy for larynx preservation patient selection or therapeutic effect?","volume":"24","author":"Pfiser DG","year":"2006","journal-title":"J Clin Oncol"},{"issue":"Suppl 2","key":"ref7","first-page":"7","article-title":"Influential factors, complications and survival rate of primary and salvage total laryngectomy for advanced laryngeal cancer","volume":"36","author":"Stankovic M","year":"2012","journal-title":"Coll Antropol"},{"issue":"5","key":"ref8","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1002\/ijc.20740","article-title":"Trends in incidence and prognosis for head and neck cancer in the United States a site-specific analysis of the SEER database","volume":"114","author":"Carvalho AL","year":"2005","journal-title":"Int J Cancer"},{"issue":"9","key":"ref9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.mlg.0000236095.97947.26","article-title":"Laryngeal cancer in the United States: changes in demographics, patterns of care, and survival","volume":"116","author":"Hoffman HT","year":"2006","journal-title":"Laryngoscope"},{"issue":"Suppl 3","key":"ref10","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1634\/theoncologist.2010-S3-30","article-title":"Candidates for larynx preservation the next step?","volume":"15","author":"Lefebvre JL","year":"2010","journal-title":"Oncologist"},{"issue":"9","key":"ref11","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1007\/s00405-009-1028-2","article-title":"Current trends in initial management of laryngeal cancer the declining use of open surgery","volume":"266","author":"Silver CE","year":"2009","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"22","key":"ref12","doi-asserted-by":"crossref","first-page":"3693","DOI":"10.1200\/JCO.2006.07.4559","article-title":"American Society of Clinical Oncology clinical practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer","volume":"24","author":"Pfister DG","year":"2006","journal-title":"J Clin Oncol"},{"issue":"5","key":"ref13","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1016\/j.ijrobp.2008.10.047","article-title":"Larynx preservation clinical trial design key issues and recommendations: a consensus panel summary","volume":"73","author":"Lefebvre JL","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"12","key":"ref14","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1001\/archotol.133.12.1270","article-title":"Factors predictive of survival in advanced laryngeal cancer","volume":"133","author":"Chen AY","year":"2007","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"5","key":"ref15","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1002\/hed.21739","article-title":"Diagnosis and treatment of recurrent laryngeal cancer following initial nonsurgical therapy","volume":"34","author":"Agra IM","year":"2012","journal-title":"Head 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