Publication:

T1 and T2 glottic squamous cell carcinoma: endoscopic laser surgery versus radiotherapy experience in a cancer center in Mexico

Background Radiotherapy and endoscopic laser surgery (ELS) has been considered the primary treatment for laryngeal cancer. This study aims to compare ESL and radiotherapy in terms of organ preservation, disease-free survival, overall survival and cancer-specific survival.

Methods A retrospective study using database of T1-T2 glottic cancer treated with radiotherapy and ELS. Disease-free survival, overall survival and cancer specific survival (CSS) for both groups according to Kaplan-Meier.

Results 108 patients received radiotherapy and 98 patients underwent ELS were analyzed. Organ preservation rate was higher in the ELS group (88.8% vs 84.3%) p=NS. The percentage of patients alive without disease was higher in the ELS group (85.7% vs 58.3%) (p< 0.00). The five-year general OS rates were 93% and 91% in the ELS and radiotherapy group, respectively; while the ten-year OS rates were 93% and 63%, respectively. The five-year and ten-year OS rates for T1 and T2 (p=NS). Five-year CSS in the ELS and radiotherapy group was, respectively, 86% and 85%, whereas ten-year CSS was 83% and 50%, respectively (p=NS). A sub analysis of recurrent cases was performed for both groups. Organ preservation was achieved in 71.1% of cases in the ELS group compared with 58% in the radiotherapy group (p=0.23).

Conclusions T1 tumors should be exclusively treated with ELS or open surgery, diagnosis and treatment can be combined in a single surgical procedure. Before administering radiotherapy, a diagnosis is needed. T2 tumors should be properly selected for their management and many approaches are available. Organ preservation is similar for both groups.