T1 squamous cell carcinoma of the glottis with anterior commissure involvement: Radiotherapy versus transoral laser microsurgery

Head Neck. 2017 Jun;39(6):1101-1105. doi: 10.1002/hed.24723. Epub 2017 Mar 28.

Abstract

Background: The optimal treatment method of T1 glottic squamous cell carcinoma (SCC) with involvement of the anterior commissure is still debatable. We compared the outcomes of radiotherapy (RT) and transoral laser microsurgery (TLM).

Methods: Data were retrospectively collected for 54 patients who were treated by RT (n = 38) or TLM (n = 16) from 2006 to 2013.

Results: No between-group differences were found in demographic or risk factors. Recurrence was noted in 6 patients of the TLM group and 5 of the RT group. There was a near-significant association of TLM with recurrence (p = .053). Radiation was associated with a higher 5-year disease-free survival (DFS) (87.3% vs 74.9%; p = .037). Both groups had excellent rates for local control (75% and 97%, respectively), and overall survival (78.9 and 87.5%, respectively). There were no significant differences in outcome parameters by tumor classification.

Conclusion: TLM is associated with higher recurrence rates and lower DFS. Both patients with T1a and T1b disease had the same outcome parameters. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1101-1105, 2017.

Keywords: commissure; early glottic carcinoma; laser surgery; radiation; recurrence; squamous cell carcinoma (SCC); treatment.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Carcinoma, Squamous Cell / surgery*
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Glottis / pathology*
  • Glottis / surgery
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / radiotherapy*
  • Laryngeal Neoplasms / surgery*
  • Laser Therapy / methods*
  • Male
  • Microsurgery / methods
  • Middle Aged
  • Mouth
  • Natural Orifice Endoscopic Surgery / methods
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Prognosis
  • Proportional Hazards Models
  • Radiotherapy, Conformal
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome