Sage Journals: Discover world-class research

Abstract

Objective

Single-modality treatment, either with organ preservation surgery (OPS) or definitive radiation (RT), is the treatment of choice for patients with early supraglottic squamous cell carcinoma (SGC). However, studies comparing the effectiveness of these 2 techniques are lacking. This study compares the survival outcomes in early SGC patients treated with OPS versus RT.

Study Design

Secondary data analysis.

Setting

Surveillance, Epidemiology and End Results database.

Subjects and Methods

This study included adult patients with early-stage (T1N0, T2N0) SGC undergoing single-modality treatment with either OPS (with or without neck dissection [ND]) or RT between 1988 and 2008. Survival analysis was used to compare the overall survival (OS) and disease-specific survival (DSS) between patients treated with OPS+ND, OPS alone, and RT.

Results

A total of 2631 T1/T2 N0 SGC patients were identified, of whom 167 (6%) were treated with OPS+ND, 186 (7%) with OPS only, and 2278 patients (87%) with definitive RT only. In stage I (T1N0) SGC patients, a significantly better 5-year DSS was noted for both OPS+ND (81% vs 68%, hazard ratio [HR] = 0.61, P = .03) and OPS only (82% vs 68%, HR = 0.70, P = .05) when compared with definitive RT. For stage II (T2N0) patients, only OPS+ND resulted in a significantly better 5-year DSS (86% vs 60%, HR = 0.31, P < .001) when compared with patients treated with RT.

Conclusions

Patients with early SGC who underwent OPS+ND had better OS and DSS than patients undergoing RT alone. OPS+ND may be considered a viable and preferred treatment option in these patients.

Keywords

supraglottic squamous cell carcinoma organ preservation surgery definitive radiotherapy over survival disease-specific survival

Get full access to this article

View all access options for this article.

References

Piccirillo

FJC

. I. Cancer of the Larynx in SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. Vol NIH Pub. No. 07-6215. Bethesda, MD: National Cancer Institute, SEER Program; 2007.

National Comprehensive Cancer Network. (2012). NCCN clinical practice guidelines in oncology. In Head and Neck Cancers (version 1.2012, pp. MS19). http://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf.

Sessions

Lenox

Spector

. Supraglottic laryngeal cancer: analysis of treatment results. Laryngoscope. 2005;115:1402-1410.

Groome

O’Sullivan

Irish

. Glottic cancer in Ontario, Canada and the SEER areas of the United States: do different management philosophies produce different outcome profiles? J Clin Epidemiol. 2001;54:301-315.

Groome

O’Sullivan

Irish

. Management and outcome differences in supraglottic cancer between Ontario, Canada, and the Surveillance, Epidemiology, and End Results areas of the United States. J Clin Oncol. 2003;21:496-505.

Spriano

Antognoni

Piantanida

. Conservative management of T1-T2N0 supraglottic cancer: a retrospective study. Am J Otolaryngol. 1997;18:299-305.

Hinerman

Mendenhall

Amdur

Stringer

Villaret

Robbins

. Carcinoma of the supraglottic larynx: treatment results with radiotherapy alone or with planned neck dissection. Head Neck. 2002;24:456-467.

Surveillance, Epidemiology, and End Results (SEER) Program (http://www.seer.cancer.gov) Research Data (1973-2008), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2011, based on the November 2010 submission.

National Cancer Institute. Overview of the Surveillance, Epidemiology, and End Results Program. http://seer.cancer.gov/about/overview.html.

10.

Egner

. AJCC cancer staging manual. JAMA. 2010;304:1726-1727.

11.

Jones

Fish

Fenton

Husband

. The treatment of early laryngeal cancers (T1–T2 N0): surgery or irradiation? Head Neck. 2004;26:127-135.

12.

Parsons

Mendenhall

Stringer

Cassisi

Million

. Salvage surgery following radiation failure in squamous cell carcinoma of the supraglottic larynx. Int J Radiat Oncol Biol Phys. 1995;32:605-609.

13.

Holsinger

Funk

Roberts

Diaz

Jr . Conservation laryngeal surgery versus total laryngectomy for radiation failure in laryngeal cancer. Head Neck. 2006;28:779-784.

14.

Myers

Wagner

Johnson

. Microlaryngoscopic surgery for T1 glottic lesions: a cost-effective option. Ann Otol Rhinol Laryngol. 1994;103:28-30.

15.

Phillips

Sader

Brown

. Transoral laser microsurgery versus radiation therapy for early glottic cancer in Canada: cost analysis. Otolaryngol Head Neck Surg 2009;38:619-623.

16.

Guzzo

Ferraro

Rezzonico

. Open organ preservation surgery of the larynx: experience of Istituto Nazionale Tumori of Milan. Head Neck. 2011;33:673-678.

17.

Karatzanis

Psychogios

Zenk

. Evaluation of available surgical management options for early supraglottic cancer. Head Neck. 2010;32:1048-1055.

18.

Mendelsohn

Remacle

Van Der Vorst

Bachy

Lawson

. Outcomes following transoral robotic surgery: supraglottic laryngectomy. Laryngoscope. 2013;123:208-214.

19.

Ozer

Alvarez

Kakarala

Durmus

Teknos

Carrau

. Clinical outcomes of transoral robotic supraglottic laryngectomy. Head Neck. 2013;35:1158-1161.

Survival Differences between Organ Preservation Surgery and Definitive Radiotherapy in Early Supraglottic Squamous Cell Carcinoma