Abstract
There are conflicting reports about whether radiotherapy or surgery is optimal for early‐stage laryngeal squamous cell carcinoma (LSCC), although both have recently been recommended. Patients with T1‐2N0M0 LSCC in the population‐based SEER database who underwent radiotherapy or surgery were reviewed. Propensity score matching was used to eliminate the baseline variations. After matching, 1913 pairs of patients were included. Overall, patients who received radiotherapy had worse cancer‐specific survival than patients with surgery. After stratification, the survival in patients who received radiotherapy was worse with respect to the following characteristics: ≤60 years of age; T1a glottis cancer; well‐differentiated tumors; and with married status. In other patients, survival outcomes were similar in patients who received radiotherapy and underwent surgery. Our results indicate that radiotherapy is not preferable in early‐stage LSCC patients who are ≤60 years of age, have T1a glottis cancer or well‐differentiated tumors, or are married. In other patients, both radiotherapy and surgery are comparable. However, our results cannot be a reference before controlled, prospective trials are performed.
Highlights
As one of the most common cancers worldwide, laryngeal carcinoma accounts for estimated 160 000 new cases and 90 000 deaths every year, of which >95% are squamous cell carcinomas.[1,2,3] Depending on the disease stage at diagnosis, the primary management strategies for patients with laryngeal squamous cell carcinoma (LSCC) mainly consist of surgery and/or radiotherapy
We found that only patients with stage T1a glottic cancer who underwent surgery had superior survival to radiotherapy, while there was no significant difference in T1b and T1 not specified glottic cancer, as shown in Figures 4 and S2
Our study indicated a hypothesis that patients with T1a stage of glottis cancer who were ≤60 years of age, married, or with well-differentiated tumors treated with radiotherapy had worse survival outcomes than patients treated with surgery
Summary
As one of the most common cancers worldwide, laryngeal carcinoma accounts for estimated 160 000 new cases and 90 000 deaths every year, of which >95% are squamous cell carcinomas.[1,2,3] Depending on the disease stage at diagnosis, the primary management strategies for patients with laryngeal squamous cell carcinoma (LSCC) mainly consist of surgery and/or radiotherapy. 60% and 100% in several studies, the optimal treatment strategy has not been determined.[4] According to the latest NCCN guidelines, surgery or definitive radiotherapy can be used for curing T1-2N0M0 LSCC. | 2838 prevalence, and survival from specific geographic areas and compiled reports on all of these plus cancer mortality.[9] Using cases in SEER, we attempted to determine whether the radiation or surgery could be an optimal treatment regimen for patients with T1-2 N0M0 LSCC in this study. It is noteworthy that our results cannot be a reference before controlled, prospective trials are performed
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