H&N E28: Organ Preservation The Landmark Trials

This episode, number 28, explores "Organ Preservation: The Landmark Trials." Prior to 1991, the standard treatment for advanced laryngeal cancer involved total laryngectomy and radiation, which, while ensuring patient survival, resulted in the loss of natural voice, the inability to breathe through the nose and mouth, and a permanent stoma. A pivotal question emerged: could equivalent survival rates be achieved while preserving the larynx? Landmark trials provided an affirmative answer, emphasizing the importance of appropriate patient selection and treatment strategies. However, long-term follow-up studies revealed concerning late toxicities associated with larynx-preserving treatments, which may impact survival in complex, still-unresolved ways. In this episode, we will analyze the VA Larynx, RTOG 91-11, and GORTEC 2000-01 trials, providing insights for both board preparation and clinical practice. By the conclusion, listeners will not only comprehend the trials' findings but also learn how to apply them effectively to real-world patient care.