T1-2 Glottic Squamous Cell Carcinoma: Endoscopic Laser Surgery vs Radiotherapy Experience in Mexico

Abstract

Objective: 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 subanalysis 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). Conclusion: 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. Evidence level: 3