Prognostic impact of initial treatment in surgically salvaged recurrences of early glottic cancer

Laryngoscope. 2019 Oct;129(10):2328-2333. doi: 10.1002/lary.27702. Epub 2018 Dec 18.

Abstract

Objective: The purpose of this study was to analyze the outcomes of surgically salvaged early glottic cancer (EGC) recurrences after initial radiotherapy (RT) or transoral laser microsurgery (TLM).

Methods: A matched pair analysis by recurrent tumor-node-metastasis stage (rTNM) considering 27 patients who had TLM as initial treatment and 54 patients who failed after primary RT was performed. Post-recurrence overall and disease-specific survival (DSS) were evaluated.

Results: The RT-failed group showed worse post-recurrence overall survival (P < .001) and DSS (P = .005) compared to TLM-first group despite the same rTNM stage. The RT failed patients also showed more postoperative complications (longer mean decannulation time, P = .005; nasogastric feeding tube dependence, P = .012) and a higher rate of second locoregional recurrences (P = .004).

Conclusion: The RT-failed EGC showed worse outcomes in terms of survival, complications, and locoregional recurrences compared to same recurrent TNM stage TLM-failed cases.

Level of evidence: 3 Laryngoscope, 129:2328-2333, 2019.

Keywords: Laryngeal cancer; early glottic cancer; otorhinolaryngology; radiotherapy; transoral laser microsurgery.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Databases, Factual
  • Disease-Free Survival
  • Female
  • Glottis / surgery
  • Humans
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / surgery*
  • Laser Therapy / methods
  • Laser Therapy / mortality*
  • Male
  • Microsurgery / methods
  • Microsurgery / mortality*
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality*
  • Prognosis
  • Retrospective Studies
  • Salvage Therapy / methods
  • Salvage Therapy / mortality*
  • Treatment Outcome