Survival outcomes in patients with T3-4aN0M0 glottic laryngeal squamous cell carcinoma and evaluation of postoperative radiotherapy

Jian Zhou; Yu Heng; Yue Yang; Xiaoke Zhu; Liang Zhou; Hongli Gong; Chengzhi Xu; Lei Tao

doi:10.3892/ol.2022.13554

Survival outcomes in patients with T3-4aN0M0 glottic laryngeal squamous cell carcinoma and evaluation of postoperative radiotherapy

Oncol Lett. 2022 Oct 19;24(6):434. doi: 10.3892/ol.2022.13554. eCollection 2022 Dec.

Authors

Jian Zhou¹, Yu Heng¹, Yue Yang¹, Xiaoke Zhu¹, Liang Zhou¹, Hongli Gong¹, Chengzhi Xu¹, Lei Tao¹

Affiliation

¹ Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, P.R. China.

Abstract

This study aimed to evaluate the clinical outcomes of patients with T3-4aN0M0 glottic laryngeal squamous cell carcinoma (LSCC) treated with laryngectomy, and to assess the postoperative radiotherapy (PORT) results in terms of the survival of T3-T4aN0M0 patients with negative margins. This was a retrospective review of 369 T3-4aN0M0 glottic LSCC cases. The 5-year cancer-specific survival (CSS) and overall survival (OS) rates were 67.5 and 66.7%, respectively. Patients who received total laryngectomy had worse survival [5-year CSS, 62.5%; disease-free survival (DFS), 56.2%] than those who underwent partial laryngectomy (5-year CSS, 79.3%; DFS, 65.4%). More advanced-stage cancer is a predictor of poor survival. There was no significant difference in CSS or DFS between patients with positive margins following rescue therapy and those with negative margins. Furthermore, no difference in the survival rates was observed between patients with negative margins who received PORT and those who did not (5-year DFS: 59.1 vs. 63.8%, P=0.057 and CSS: 62.5 vs. 69.5%, P=0.074). For T3-4aN0M0 glottic LSCC patients, surgical treatment remained a good option, as it can achieve satisfactory oncological outcomes. However, PORT did not increase survival in surgically managed pT3-4aN0M0 LSCC patients with negative margins.

Keywords: T3-4aN0M0; laryngeal squamous cell carcinoma; postoperative radiotherapy; surgery; survival outcomes.

Grants and funding

This work was sponsored by the Major Clinical Research Project of Shanghai Shen-kang Hospital Clinical Development Center (grant no. SHDC2020CR6011); the Science and Technology Innovation Project of Shanghai Shen-kang Hospital Clinical Development Center (grant no. SHDC12015114); the National Natural Science Foundation of China (grant nos. 82003178, 81772878, 30801283, and 30972691); Shanghai Sailing Program (grant no. 19YF1405900), the Shanghai Municipal Key Clinical Specialty (grant no. shslczdzk00801); the Science and Technology Committee of Shanghai (grant no. 20MC1920200); the Science and Technology Commission of Shanghai Municipality (grant no. 20Y11902200); the Shanghai Anti-Cancer Development Foundation (grant no. H6001-008); and the Training Program of the Excellent Doctors of Fudan University (grant no. QT00140).