Survival differences between organ preservation surgery and definitive radiotherapy in early supraglottic squamous cell carcinoma

Hassan Arshad, Vijayvel Jayaprakash, Vishal Gupta, David M. Cohan, Dildeep Ambujakshan, Nestor R. Rigual, Anurag K. Singh, Wesley L. Hicks

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Objective. Single-modality treatment, either with organ preservation surgery (OPS) or definitive radiation (RT), is the treatment of choice for patients with early supraglottic squamous cell carcinoma (SGC). However, studies comparing the effectiveness of these 2 techniques are lacking. This study compares the survival outcomes in early SGC patients treated with OPS versus RT. Study Design. Secondary data analysis. Setting. Surveillance, Epidemiology and End Results database. Subjects and Methods. This study included adult patients with early-stage (T1N0, T2N0) SGC undergoing single-modality treatment with either OPS (with or without neck dissection [ND]) or RT between 1988 and 2008. Survival analysis was used to compare the overall survival (OS) and disease-specific survival (DSS) between patients treated with OPS1ND, OPS alone, and RT. Results. A total of 2631 T1/T2 N0 SGC patients were identified, of whom 167 (6%) were treated with OPS1ND, 186 (7%) with OPS only, and 2278 patients (87%) with definitive RT only. In stage I (T1N0) SGC patients, a significantly better 5-year DSS was noted for both OPS1ND (81% vs 68%, hazard ratio [HR] = 0.61, P = .03) and OPS only (82% vs 68%, HR = 0.70, P = .05) when compared with definitive RT. For stage II (T2N0) patients, only OPS1ND resulted in a significantly better 5-year DSS (86% vs 60%, HR = 0.31, P <.001) when compared with patients treated with RT. Conclusions. Patients with early SGC who underwent OPS1ND had better OS and DSS than patients undergoing RT alone. OPS1ND may be considered a viable and preferred treatment option in these patients.

Original languageEnglish
Pages (from-to)237-244
Number of pages8
JournalOtolaryngology - Head and Neck Surgery
Volume150
Issue number2
DOIs
StatePublished - Feb 2014
Externally publishedYes

Keywords

  • definitive radiotherapy
  • disease-specific survival
  • organ preservation surgery
  • over survival
  • supraglottic squamous cell carcinoma

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