Cancer Res Treat.  2018 Jan;50(1):156-163. 10.4143/crt.2016.503.

Radiotherapy Versus Cordectomy in the Management of Early Glottic Cancer

• Chung SY
• Kim KH
• Keum KC
• Koh YW
• Kim SH
• Choi EC
• Lee CG

• KMID: 2403485
• DOI: http://doi.org/10.4143/crt.2016.503

Abstract

PURPOSE
The purpose of this study was to compare the treatment outcomes of definitive radiotherapy (RT) with cordectomy in patients with early glottic cancer.
MATERIALS AND METHODS
A total of 165 patients who were diagnosedwith T1/2 squamous cell carcinoma of the glottic larynx between January 2006 and December 2012 were retrospectively analyzed. A total of 112 patients received RT and 53 patients received cordectomy. Local control (LC), disease-free survival (DFS), overall survival (OS), and larynx preservation rates after RT and cordectomy were investigated.
RESULTS
The median follow-up period was 77.7 months (range, 10.7 to 127.0 months). The 3- and 5-year LC rates were 91.9% and 89.9%, respectively, for the RT group, and 82.8% and 73.2%, respectively, for the cordectomy group (p=0.006). The 3- and 5-year DFS rates were 87.5% and 83.7%, respectively, for the RT group and 79.2% and 68.0%, respectively, for the cordectomy group (p=0.046). No significant differences were identified in the 5-year OS (92.8% vs. 90.6%, p=0.713) or larynx preservation rates (98.2% vs. 97.2%, p=0.831) between groups. The major failure pattern was local failure (n=26), followed by regional (n=3) and distant failure (n=2). Multivariate analysis of LC showed that T2 stage (p=0.012) and receiving cordectomy as initial treatment (p=0.001) were significantly associated with poorer LC.
CONCLUSION
RT resulted in higher rates of LC and DFS compared to cordectomy for early glottic cancer. Treatment with radiotherapy is feasible and should be encouraged for both T1 and T2 glottic cancer.

Keyword

Laryngeal neoplasms; Radiotherapy; Local neoplasm recurrence

MeSH Terms

Carcinoma, Squamous Cell
Disease-Free Survival
Follow-Up Studies
Humans
Laryngeal Neoplasms
Larynx
Multivariate Analysis
Neoplasm Recurrence, Local
Radiotherapy*
Retrospective Studies

Figure

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  Fig. 1. Kaplan-Meier estimates of local control for T1 and T2 glottic cancer (A) and Kaplan-Meier estimates of local control for T1 glottic cancer (B). RT, radiotherapy.

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  Fig. 2. Kaplan-Meier estimates of disease-free survival. RT, radiotherapy.

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  Fig. 3. Kaplan-Meier estimates of overall survival. RT, radiotherapy.

Reference

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