Advanced Laryngeal Cancer

What was the key conclusion of the VA Laryngeal Cancer Study?

• TL for stage IV laryngeal SCC provides best survival outcomes

• Early stage laryngeal SCC can be treated with chemotherapy alone

• Total laryngectomy is the ideal method of laryngeal preservation

• ChemoRT can preserve larynx in 2/3 of late stage patients without compromising survival

Which non-surgical treatment of laryngeal SCC has best laryngeal preservation and locoregional control per RTOG 91-11?

• Concurrent chemoRT

• Induction chemo followed by RT

• RT alone

• Total laryngopharyngectomy

What structures are located just lateral to the lesser cornu of the hyoid bone?

• Vallecula and piriform sinus mucosa

• Lingual nerve and submandibular ganglion

• Hypoglossal nerve and lingual artery

• Recurrent laryngeal nerve and parathyroid gland

What lies just medial to the greater horn of the thyroid cartilage?

• Vallecula

• Laryngeal Vestibule

• Piriform Sinus

• Tonsillar Fossa

On preoperative DL, tumor is found to involve bilateral TVF with extension to LEFT false fold/AE fold and LEFT piriform. Where should you perform your pharyngotomy during TL?

• LEFT vallecula

• RIGHT vallecula

• LEFT piriform

• Midline post-cricoid

What is the suture technique used to invert pharyngeal mucosa?

• Connell Suture

• 3-0 Prolene

• Running Submucoscular

• Darrell Suture

After controlling for stage, esophageal SCC and adenocarcinoma have similar survival rates.

• True

• False

Which subsite of the larynx has the highest risk for distant metastasis?

• Supraglottis

• Glottis

• Subglottis

What was the 2-year laryngeal preservation rate for concurrent chemoradiation in RTOG 91-11?

• 25%

• 50%

• 75%

• 90%

Tumors in which hypopharyngeal subsite are associated with Plummer-Vinson Syndrome?

• Vallecula

• Post-Cricoid

• Piriform Sinus

• Posterior Pharyngeal Wall