Comparison of long‑term treatment outcomes of T2N0M0 laryngeal squamous cell carcinoma using different treatment methods

Abstract

Early [stage I and II (T2N0M0)] laryngeal cancer types are currently recommended to be treated with a single modality, consisting of definitive radiation therapy or larynx-preserving surgery. Although the treatment outcomes of stage I are good, the frequency of successful outcomes decreases with T2N0M0. Therefore, the present study investigated the treatment outcomes of different treatment methods in T2N0M0 laryngeal cancer. In total, 83 patients with previously untreated T2N0M0 laryngeal squamous cell carcinoma were enrolled. Patients were grouped by treatment method: Radiation therapy (RT; 27 patients); chemoradiotherapy (CRT; 46 patients) with cisplatin base; and surgery-based therapy (SBT; ten patients). The recurrence rates of the RT, CRT and SBT groups were 44.4, 19.6 and 50%, respectively. Moreover, the local control rates of the RT, CRT and SBT groups were 55.6, 87.0 and 80%, respectively. The CRT group had a significantly lower recurrence rate and higher local control rate compared with the RT group (P<0.05). In the survival analysis, overall and disease-specific survival rate did not differ significantly among the treatment groups. However, 3-and 5-year disease-free survival rates (DFS) of the RT group were both 55%, those of the SBT group were both 50% and those of the CRT group were both 80%. Furthermore, the DFS was significantly higher in CRT group compared with the other groups (P= 0.02). Using multivariate analysis with Cox regression, it was found that the treatment method was the most important factor for DFS and had a significant impact in the CRT group. In addition, in patients with glottic cancer with anterior commissure and subglottic invasion, the CRT group had significantly improved DFS compared with the RT group, whereas there was no significant difference between the two groups in patients without subglottic invasion. According to National Cancer Institution Common Toxicity Criteria (version 5.0), more patients had toxicity in the CRT group compared with the RT group. However, in the RT and CRT groups, no patients demonstrated mortality due to toxicity, and treatment-related toxicities were manageable. Collectively, although definitive conclusions could not be established, due to the limitations of this retrospective study, the results suggest that CRT had a positive impact on the local control and DFS rates with manageable toxicity in patients with T2N0M0 laryngeal cancer.

Preoperative nomogram based on CT imaging to predict recurrence of early-stage glottic cancer after larynx-preserving surgery

“…Meanwhile, there is a more obvious tendency for recurrence of T2-stage tumors than T1-stage tumors; this seems to be consistent with the results reported in the literature (19). It is hypothesized that some patients with tumors classi ed as T2 stage may actually have tumors that should be classi ed as T3 stage (with minor paraglottic and pre-epiglottic space invasion); these are sometimes di cult to identify on a CT scan (20).…”

Oncological outcomes of surgical management for T2N0M0 glottic laryngeal squamous cell carcinoma

“…The therapy results of the T2N0M0 laryngeal tumor are inferior to that of the T1N0M0, despite the same initial phase being considered [20,21]. Previous researches of conventional RT have described the veyear local control rates of 84-95% for T1a and 50-85% for T2 glottic tumors [14,22,23]. T2N0M0 patients have a 25-50% recurrence rate, which is two times higher than that of T1N0M0 patients, owing to local failure in the laryngeal tumor.…”

Hypofractionated (2.75 Gy per fraction) versus Conventionally Fractionated Primary Radiotherapy for T2N0M0 Carcinoma of the Glottis

“…29 A recently published retrospective study reported better LC in patients with T2N0M0 glottis cancer treated with chemoradiotherapy as compared with radiotherapy alone (55.6% vs. 87.0%, p < 0.05), though these results must be verified in a randomized prospective trial. 30 …”