Among patients with T3 glottic squamous cell carcinoma (SCC), those who underwent surgery had an improved overall survival, in contrast with those who opted for nonsurgical treatment, according to a study published in JAMA Otolaryngology–Head & Neck Surgery.1
T3 glottic SCC is a unique form of laryngeal cancer. Because there are limited data surrounding the outcomes of available treatment modalities for this subtype of head and neck cancer, researchers contrasted overall survival and functional outcomes of patients who received surgical management with those who had nonsurgical treatment.
Investigators analyzed data from 487 patients with T3 glottic SCC included in the Surveillance, Epidemiology, and End Results (SEER) registry and Medicare databases. Patients were diagnosed between 1992 and 2010, and had received surgery with or without adjuvant radiotherapy and/or chemotherapy.
Results showed that the 5-year overall survival rate for nonsurgical management, surgery alone, and surgery plus adjuvant therapy were 36% (95% CI, 30-42), 41% (95% CI, 30-53), and 41% (95% CI, 32-51), respectively.
After adjusting for multiple variables, researchers found that patients receiving surgery alone had a 32% reduce risk of death, in contrast with nonsurgical management (hazard ratio, 0.68; 95% CI, 0.49-0.94). Patients receiving surgery plus adjuvant therapy had a 25% reduced risk of death versus nonsurgical management (hazard ratio, 0.75; 95% CI, 0.57-0.98).
The study demonstrated, however, that patients receiving the surgery plus adjuvant therapy had the highest rate of gastrostomy tube dependence (30.6%), and that those receiving chemoradiotherapy had the highest tracheostomy dependence (37.0%).
These findings suggest that adjuvant treatment and nonsurgical management are associated with a dysfunctional larynx, but further investigation of this relationship is necessary.
- Al-Gilani M, Skillington SA, Kallogjeri D, Haughey B, Piccirillo JF. Surgical vs nonsurgical treatment modalities for t3 glottic squamous cell carcinoma. JAMA Otolaryngol Head Neck Surg. 2016 Jul 7. doi: 10.1001/jamaoto.2016.1609 [Epub ahead of print]