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

Abstract

Objectives: The research aimed to evaluate the clinical treatment outcomes of T2N0M0 glottic laryngeal squamous cell carcinoma (LSCC) patients who underwent laryngectomy.

Methods: Retrospective review of 533 T2N0M0 glottic LSCC patients.

Results: Five-year cancer-specific survival (CSS) rate was 90.0%, and the overall survival (OS) rate was 89.1%. No statistically difference was found between the patients who have undergone total laryngectomy (5-year disease-free survival[DFS] = 80.7%, and the CSS = 86.7%) and those who have had partial laryngectomy (the 5-year DFS = 85.3%, and CSS = 91.1%). There was no difference in the CSS and DFS rates between patients with negative margins and those with positive margins following postoperative radiotherapy (PORT) ± chemotherapy (the CSS: 90.8% vs. 81.8%, p = 0.458 and 5-year DFS: 84.6% vs. 79.5%, p = 0.371). Patients who underwent vertical partial laryngectomy (VPL) had better survival (5-year OS was 91.9%, and the CSS was 92.8%) than those who underwent cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) (the 5-year OS = 83.8%, p = 0.022 and CSS = 84.9%, p = 0.038).

Conclusions: Surgery remains the gold standard for treating T2N0M0 glottic LSCC patients because it can achieve satisfactory oncological outcomes. Regarding the systemic conditions, the effect of partial laryngectomy is similar to that of total laryngectomy. Moreover, partial laryngectomy preserves the function of the larynx. VPL may be superior to CHP/CHEP, depending upon the invasiveness of the tumor.