09-11, 17:00–17:30 (Europe/Istanbul), Head & Neck Surgery 4
Better endoscopic, CT and MR diagnostics of laryngeal cancer significantly improved the local assessment of the spread of cancer, especially the volume and intensity of the affected structures of the larynx. This is the basis for a better selection of patients for a certain method of treatment, especially in advanced cancers, which represent a heterogeneous group, where some respond better to surgery and others to organ preservation therapy. In the previous period, the very popular non-selective organ preservation with induction/competitive chemoradiotherapy did not give the expected results with a decrease in overall survival, worse functional results and worse quality of life. In the light of modern knowledge, the indication for chemoradiotherapy is reserved for patients with a small volume of cancer, preserved airway, good swallowing function without the need for a tracheostomy or gastrostomy or tube, limited cartilage destruction and patients who can tolerate the toxicity of chemoradiotherapy related to radiotherapy. For open surgery, it is very important to assess the degree of involvement of the paraglottic, preepiglottic space, cartilage infiltration, and spread to extralaryngeal tissues. The paraglottic space is divided into anterior and posterior compartments, so advanced carcinomas involving the anterior compartment can be treated with open laryngeal reconstructive surgery, while advanced posterior compartment carcinomas are better controlled by total laryngectomy. Reconstructive surgery involves the application of one of the horizontal laryngectomies, supraglottic, supracricoid or supratracheal. Reconstructive surgery is indicated in patients younger than ≤70 years, who are neurologically healthy and can master the procedure of postoperative swallowing rehabilitation, with good cardiopulmonary function, a tumor that does not spread too far posteriorly and/or massive involvement and ankylosis of the cricoarytenoid joint. N status affects the choice of therapy, so a low N status favors the application of surgical therapy, and a high one favors the application of organ preservation.
Good patient selection and individual application of an adequate treatment modality is the key to achieving good oncological disease control, good functional results and good quality of life.
The aim of the lecture is to explain how to achieve a good patient outcome and the individual application of an adequate treatment modality for laryngeal cancer to achieve good oncological disease control and good functional results.
Full professor of the Faculty of Medicine. Regular member of the Academy of Medical Sciences. President of the Serbian Association of Head and Neck Oncology
Current positions of Prof Milan Stankovic are: Full time Professor of Otolaryngology, Head of Otolaryngology at Medical Faculty University of Nis Serbia, Instuctor of European Academy of Otology and Otoneurology, Ambassador to American Academy of Otolaryngology, Visiting Professor at Ahepa University Hospital Thessaloniki, Greece, International Elector at University in Athens, Thessaloniki, Larisa, Iraklion (Greece), Honorary Member of Italian Rhinologic Society, Honorary Member of ENT Society of Northern Greece, Contributor to Encyclopedia of ORL ( Springer, New York), Editor in World Articles of Otolaryngology, Member of Editorial Board for International Advanced Otology, Balkan Jounal of Medicine, Journal of Hearing Science, etc.
He was: President of Balkan Society of Otolaryngology, Board Member of Balkan ORL Society, Vice President of Serbian ORL Society, and Regional Secretary of European Academy of Otology and Otoneurology.
He published chapters in Books (Encyclopedia of ORL, Atlas of Operative Otolaryngology, Handbook of Pharyngeal Diseases), and papers in: Am J Otolaryngol, Eur Arch ORL, Otol Neurotol, ORL Karger, Acta Byophys Biochem, Pro Otology, International Advanced Otology, etc.
During international Congresses he was frequently Chairperson and Round table speaker at many Congresses, also Invited speaker at International Congresses , and as Instructor of European Academy of Otology.
Postgraduate education of Prof Stankovic included: ENT Clinics in Geneva, Zurich, Basel (1989 to 1990), Cornel University Saltzburg ENT Seminar (1997), ENT Clinic University Hospital Vienna (2000), ENT Clinics in Tokio and Osaka, Japan (2004), ENT Clinic Charite Berlin, Germany (2006).