- The relative benefits of partial laryngectomy (PL), total laryngectomy (TL), and primary chemoradiotherapy (CRT) vary by T stage and nodal burden in patients with stage III/IV laryngeal squamous cell carcinoma (SCC).
Why this matters
- The optimal treatment modalities for laryngeal SCC remain controversial, particularly regarding larynx-preserving strategies vs surgery.
- Overall, CRT was associated with similar survival to PL (aHR, 1.02; P=.750) and TL (aHR, 0.97; P=.412).
- In stratified analysis, TL followed by adjuvant RT/CRT was associated with improved survival vs definitive CRT (aHR, 0.88; P=.016).
- In patients with non-T4, low-nodal-burden (T2N1 or T3N0-N1) disease, CRT was associated with similar survival to PL (aHR, 0.87; P=.111) and TL (aHR, 1.02; P=.775).
- In patients with non-T4, high-nodal-burden (T2-T3N2-N3) disease, TL was associated with worse survival than CRT (aHR, 1.25; P=.016).
- In patients with T4N0-N3 disease, TL was associated with better survival than CRT (aHR, 0.80; P=.002).
- 8703 patients with stage III/IV laryngeal SCC from the National Cancer Database were analyzed for associations between treatment modality and survival outcomes.
- Funding: None disclosed.
- Retrospective study of large database.