Diversity of treatment of T2N0 glottic cancer of the larynx: lessons to learn from epidemiological cancer registry data

Abstract

Conclusion. Neither elective selective neck dissection nor any conservative treatment option in pT2cN0 glottic cancer showed a significant advantage on survival. This should be the basis for future treatment standardization. Obligatory documentation of the R status and cause of death in the cancer registries will improve the data interpretation in the future. Objectives. Optimal adjuvant treatment of pT2cN0 glottic cancer is not well defined. The impact of neck dissection or radio(chemo)therapy for better outcome is unknown. Methods: In a retrospective cancer registry study we analyzed the survival of 73 patients with pT2cN0 glottic cancer in Thuringia, Germany, treated surgically between 1996 and 2005. Results: In all, 35 patients had undergone elective neck dissection, the remaining 38 patients had not. Histopathology revealed occult lymph node metastasis in three patients. Adjuvant radiotherapy was delivered to 17 patients and radiochemotherapy to 4. Overall, 52 patients received an adjuvant treatment. The 5-year recurrence-free survival rate was 60.8% and the 5-year overall survival rate was 56.5%. Multivariate but not univariate analysis revealed age >62 years (p = 0.05) and neck dissection (p = 0.033) as significant negative risk factors for tumor recurrence. Looking at overall survival, the site of primary surgery and radiotherapy were significant univariate risk factors, whereas multivariate analysis did not reveal any independent risk factor. No adjuvant treatment or combinations of adjuvant treatment resulted in better recurrence-free or overall survival (p = 0.253; p = 0.279).

Keywords::

• Elective neck dissection
• cervical lymph node metastasis
• survival
• epidemiology

Acknowledgements

This work was partly presented at the 80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery, Rostock, Germany.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.