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Challenging a dogma--surgery yields superior long-term results for T1a squamous cell carcinoma of the glottic larynx compared to radiotherapy.
Thurnher, D; Erovic, B M; Frommlet, F; Brannath, W; Ehrenberger, K; Jansen, B; Selzer, E; Grasl, M C.
Afiliación
  • Thurnher D; Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Eur J Surg Oncol ; 34(6): 692-8, 2008 Jun.
Article en En | MEDLINE | ID: mdl-17686606
AIMS: The aim of this study was to compare laser surgery, conventional endoscopic surgery and radiotherapy in the treatment of early T1a glottic cancer. METHODS: We conducted a retrospective analysis of patients with early vocal cord cancer (who underwent either conventional surgery via endoscopy or laryngofissur, or primary radiotherapy) at the Medical University of Vienna. By univariate and multivariate Cox regression models the influence of treatment and other parameters on survival and locoregional control were analysed. RESULTS: 337 Patients were analyzed with a mean follow-up period of 133.8 months. Overall survival rates where similar in all three treatment groups. Five-year, 10-year and 15-year estimates of disease specific survival for laser-treated patients were 100%, for conventional surgery were 100%, 98% and 98%, and for radiotherapy were 96%, 92% and 91%, respectively. Locoregional recurrences were observed after laser surgery in 10%, after conventional surgery in 13% and after radiotherapy in 30% of the patients treated. According to the log-rank test, time to relapse was significantly shorter for irradiated patients compared to patients who underwent surgery (p < 0.0001). Mortality caused by the laryngeal tumour was significantly higher in the radiotherapy group (p = 0.003). CONCLUSION: Patients undergoing laser or conventional surgery have a significantly lower incidence of locoregional recurrences and longer disease-free intervals when compared to patients treated by radiotherapy.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pliegues Vocales / Carcinoma de Células Escamosas / Neoplasias Laríngeas / Terapia por Láser Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2008 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Reino Unido
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pliegues Vocales / Carcinoma de Células Escamosas / Neoplasias Laríngeas / Terapia por Láser Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2008 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Reino Unido