Survival and Larynx Preservation in Early Glottic Cancer: A Randomized Trial Comparing Laser Surgery and Radiation Therapy

Int J Radiat Oncol Biol Phys. 2022 May 1;113(1):96-100. doi: 10.1016/j.ijrobp.2022.01.010. Epub 2022 Feb 11.


Purpose: The prognosis of glottic T1a laryngeal squamous cell carcinoma (LSCC) is excellent with both transoral laser surgery (TLS) and radiation therapy (RT). Our aim was to compare TLS and RT treatment results in a randomized study.

Methods and materials: Of 56 male patients with glottic T1a LSCC, 31 were randomized for TLS and 25 for RT. Survival and larynx preservation data were collected from medical records.

Results: Five-year overall survival (OS) was 87%, disease-specific survival (DSS) was 97%, and recurrence-free survival (RFS) was 81% in patients treated with TLS. Five-year OS was 92%, DSS was 100%, and RFS was 88% in patients treated with RT. The primary treatment method was not associated with OS, RFS, or DSS in a log-rank test. The larynx preservation rate was similar in both groups (TLS, 97%; RT, 92%; P = .575).

Conclusions: In a prospective randomized setting oncological outcomes of both treatment modalities (TLS or RT) for T1a LSCC were similar.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Glottis / pathology
  • Glottis / surgery
  • Head and Neck Neoplasms* / pathology
  • Humans
  • Laryngeal Neoplasms* / pathology
  • Laryngeal Neoplasms* / radiotherapy
  • Laryngeal Neoplasms* / surgery
  • Laser Therapy* / methods
  • Male
  • Neoplasm Staging
  • Prospective Studies
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Survival Rate
  • Tongue Neoplasms* / pathology
  • Treatment Outcome