Analysis of prognostic factors for Tis-2N0M0 early glottic cancer with different treatment methods / Análise de fatores prognósticos para o câncer glótico inicial Tis-2N0M0 com diferentes métodos de tratamento

Abstract Introduction In many regions, laryngeal carcinoma is a common upper respiratory tract cancer, most commonly involving the glottic region. The treatment of early glottic cancer includes radiotherapy, open surgery and laryngeal laser microsurgery. However, the preferred treatment for early glottic cancer is still controversial. Objectives To study the factors affecting the 5-year survival rate of Tis-2N0M0 early glottis cancer and to demonstrate the oncological safety of different treatments. Methods 144 patients with early glottic cancer were analyzed retrospectively. All patients were clinically node negative. 53 patients underwent open surgery, transoral CO2 laser microsurgery in 46 cases and radiotherapy in 45 cases. The patients were followed up for 26 − 84 months, with an average follow-up period of 62.9 months. Results The 5-year overall survival was 82.6%. The 5 year survival rates of open surgery, laser microsurgery and radiotherapy were 83.0%, 82.6% and 82.2%, respectively. There was no significant difference in 5-year survival rate among the three treatments (p= 0.987). In multivariate analysis, age, T-stage, pathological grading, and anterior commissure involvement were important prognostic factors for early glottic cancer. Conclusion There was no significant difference in 5 year survival rate among patients treated by either radiotherapy, laser microsurgery or open surgery for early glottic cancer. We urge more attention to the age, T-stage, pathological grade, and anterior commissure involvement of the patients.

Resumo Introdução Em muitas regiões, o carcinoma de laringe é um câncer comum do trato respiratório superior e geralmente envolve a região glótica. O tratamento do câncer glótico inicial inclui radioterapia, cirurgia aberta e microcirurgia a laser de laringe. Entretanto, a forma preferencial de tratamento do câncer glótico inicial ainda é controverso. Objetivos Estudar os fatores que afetam a taxa de sobrevida em 5 anos do câncer glótico inicial Tis-2N0M0 e demonstrar a segurança oncológica de diferentes tratamentos. Método Um total de 144 pacientes com câncer glótico inicial foram analisados retrospectivamente. Todos os pacientes eram clinicamente negativos para linfonodos. Cinquenta e três pacientes foram submetidos à cirurgia aberta, 46 à microcirurgia transoral a laser de CO2, e radioterapia em 45 casos. Os pacientes foram acompanhados por 26 a 84 meses, com um período médio de seguimento de 62,9 meses. Resultados A sobrevida global em 5 anos foi de 82,6%. As taxas de sobrevida em cinco anos da cirurgia aberta, microcirurgia a laser e radioterapia foram de 83,0%, 82,6% e 82,2%, respectivamente. Não houve diferença significante na taxa de sobrevida em cinco anos entre os três tratamentos (p = 0,987). Na análise multivariada, idade, estágio T, classificação histopatológica e envolvimento da comissura anterior foram fatores prognósticos importantes para o câncer glótico inicial. Conclusão Não houve diferença significante na taxa de sobrevida em 5 anos entre radioterapia, microcirurgia a laser e cirurgia aberta para câncer glótico inicial. Deve-se estar atento à idade, estágio T, histopatológico e envolvimento da comissura anterior dos pacientes.

Analysis of prognostic factors for Tis-2N0M0 early glottic cancer with different treatment methods.

INTRODUCTION: In many regions, laryngeal carcinoma is a common upper respiratory tract cancer, most commonly involving the glottic region. The treatment of early glottic cancer includes radiotherapy, open surgery and laryngeal laser microsurgery. However, the preferred treatment for early glottic cancer is still controversial. OBJECTIVES: To study the factors affecting the 5-year survival rate of Tis-2N0M0 early glottis cancer and to demonstrate the oncological safety of different treatments. METHODS: 144 patients with early glottic cancer were analyzed retrospectively. All patients were clinically node negative. 53 patients underwent open surgery, transoral CO2 laser microsurgery in 46 cases and radiotherapy in 45 cases. The patients were followed up for 26 - 84 months, with an average follow-up period of 62.9 months. RESULTS: The 5-year overall survival was 82.6%. The 5 year survival rates of open surgery, laser microsurgery and radiotherapy were 83.0%, 82.6% and 82.2%, respectively. There was no significant difference in 5-year survival rate among the three treatments (p =  0.987). In multivariate analysis, age, T-stage, pathological grading, and anterior commissure involvement were important prognostic factors for early glottic cancer. CONCLUSION: There was no significant difference in 5 year survival rate among patients treated by either radiotherapy, laser microsurgery or open surgery for early glottic cancer. We urge more attention to the age, T-stage, pathological grade, and anterior commissure involvement of the patients.