Jerome LECHIEN
Jerome R. Lechien is head and professor of general surgery at the University of Mons. He is otolaryngologist with fellowship in laryngology and robotic head and neck surgery.
Sessions
this is a panel about reflux in every aspect
this is a panel about Istanbul Consensus: Consensus Statement about Retrograde Cricopharyngeal Dysfunction (R-CPD) Definition and Mangement
Objectives: to summarize the current literature for epidemiology, clinical management, and treatment of laryngopharyngeal reflux disease (LPRD).
Methods: Based on a PRISMA systematic search of literature, the author will provide an EBM practice for general otolaryngologists and laryngologists for the management of LPRD. A special focus will be done on the definition of LPRD, the decision to perform objective additional examination (hypopharyngeal-esophageal impedance-pH testing) or empirical therapeutic trial, the method for assessing the treatment responses, and the best therapeutic regimens. At the end of the keynote lecture, the audience should manage primary and recalcitrant LPRD.
Description: This proposal is focused on discussing the surgical feasibility of laryngeal preservation in advanced T3/T4 head and neck cancer, using the cricoarytenoid joint status as the primary assessment criterion. It is based on a a prospective, monocentric study conducted from 2020 to 2023, involving 162 patients with advanced T3/T4 squamous cell carcinoma of the head and neck. The study also assessed survival and dysphagia outcomes. Laryngeal preservation was feasible in 88% of cases when the cricoarytenoid joint was not invaded. No significant difference in recurrence-free survival was found between the laryngectomy and larynx preservation groups (78.9% vs. 85.1% recurrence-free rates). Transoral surgery resulted in faster recovery than open surgery (p = 0.001) and better overall survival (92.6% vs. 70.0%, p = 0.38). Long-term dysphagia levels and recurrence-free survival rates were similar between different surgical approaches.
Outcome Objectives: Define the theoretically possible limits for surgical preservation of the larynx and explore the possibilities of preservation surgery in advanced head and neck carcinoma beyond the theoretical red line of cricoarytenoid invasion in all directions.
Popov et al. Large monocentric prospective study on feasibility of functional preservation surgery of T3/T4 head and neck cancer - a pirouette around the cricoarytenoid joint. (under review)
Popov et al. Oncological outcomes of primary laryngectomy in T4 laryngopharyngeal cancer – study of 76 cases. Laryngorhinootologie 2019; 98(S 02): S80DOI: 10.1055/s-0039-1686049
Popov, T.M., Stancheva, G., Kyurkchiyan, S.G. et al. Global microRNA expression profile in laryngeal carcinoma unveils new prognostic biomarkers and novel insights into field cancerization. Sci Rep 12, 17051 (2022). https://www.nature.com/articles/s41598-022-20338-w
after the reflux keynote, oanel will be presented