Background: The literature reports various treatment methodologies, such as trans-oral laser microsurgery, radiation\ntherapy, total/partial laryngectomies, and concurrent radiation chemotherapy for patients with early larynx cancer.\nHowever, at the forefront of early glottis treatment is trans-oral laser microsurgery and radiation therapy, likely due to\nbetter functional and survival outcomes. Here we conduct the largest Canadian head-to-head comparison of consecutive\npatients treated with either radiation therapy or trans-oral laser microsurgery. Additionally, we compare these two\ntreatments and their 5-year survival rates post treatment to add to the existing literature.\nMethods: Charts of patients who were diagnosed with early glottic cancer between 2006 and 2013 were reviewed.\nSeventy-five patients were identified, and split into 2 groups based on their primary treatment, trans-oral laser\nmicrosurgery and radiation therapy. Kaplanââ?¬â??Meier survival curves, life-tables, and the log-rank statistic were\nreported to determine if there was a difference between the two treatment groups and their disease-specific survival,\ndisease-free survival, and total laryngectomy-free survival. Additionally, each different survival analysis was stratified by\npotential confounding variables, to help conclude which treatment is more efficacious in this population.\nResults: The 5-year disease-specific survival rate is 93.3 % ÃÆ? = 0.063 and 90.8 % ÃÆ? = 0.056 for patients treated with\ntrans-oral laser microsurgery and radiation therapy, respectively (Ãâ?¡2 < 0.001, p = 0.983). The disease free survival\nrate is 60.0 % (ÃÆ? =0.121) for patients treated with trans-oral laser microsurgery, and 67.2 % (ÃÆ? = 0.074) for those\nwho received RT (Ãâ?¡2 = 0.19, p = 0.663). Additionally, the total laryngectomy-free survival rate is 84.1 % (ÃÆ? = 0.1) and\n79.1 % (ÃÆ? = 0.072) for patientsââ?¬â?¢ early glottic cancer treated by trans-oral laser microsurgery and radiation therapy,\nrespectively (Ãâ?¡2 = 0.235, p = 0.628). Chi-square analysis of age-group versus treatment group (Ãâ?¡2 = 6.455, p = 0.04)\nand T-stage versus treatment group (Ãâ?¡2 = 11.3, p = 0.001) revealed a statistically significant relationship, suggesting\nsurvival analysis should be stratified by these variables. However, after stratification, there was no statistically significant\ndifference between the trans-oral laser microsurgery and radiation therapy groups in any of the survival analyses.\nConclusion: No difference was demonstrated in the 5-year disease-specific survival, disease-free survival, and total\nlaryngectomy-free survival, between the RT and TLM treatment groups. Additionally, both groups showed similar\n5-year survival after stratifying by confounding variables.
Loading....