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Open Access Original research article

Treatment of T1b glottic SCC: laser vs. radiation- a Canadian multicenter study

S Mark Taylor15*, Paul Kerr2, Kevin Fung3, Mankavil K Aneeshkumar1, Derek Wilke4, Yida Jiang3, John Scott1, Judith Phillips1, Robert D Hart1, Jonathan RB Trites1 and Matthew H Rigby1

Author Affiliations

1 Dalhousie University, Division of Otolaryngology – Head and Neck Surgery, Halifax, NS, Canada

2 The University of Manitoba, Department of Otolaryngology – Head and Neck Surgery, Winnipeg, Canada

3 Western University, Department of Otolaryngology – Head and Neck Surgery, London, ON, Canada

4 Dalhousie University, Department of Radiation Oncology, Halifax, NS, Canada

5 Otolaryngology - Head & Neck Surgery Facial Plastic & Reconstructive Surgery, Suite 3052, Dickson Bldg., 5820 University Avenue, Halifax, NS B3H 1V9, Canada

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Journal of Otolaryngology - Head and Neck Surgery 2013, 42:22  doi:10.1186/1916-0216-42-22

Published: 19 March 2013

Abstract

Objective

To assess the oncological and functional outcomes of T1b squamous cell carcinoma (SCC) of the glottic larynx treated with laser in comparison with radiation.

Design

A Canadian multicenter cohort study.

Setting

Three tertiary referral centers for head and neck cancer- Dalhousie University in Halifax, Nova Scotia, Western University in London, Ontario and the University of Manitoba, Winnipeg.

Methods

Patients with T1b glottic SCC who underwent transoral laser resection or radiation as the primary modality of treatment.

Outcome measures

Oncological outcomes were evaluated using local control, laryngeal preservation, disease free survival and disease specific survival. Voice outcomes were assessed using the Voice Handicap Index-10 (VHI-10).

Results

63 patients met study criteria. 21 were treated with laser and 42 with radiation. Oncologic outcomes at 2 years for laser and radiation demonstrated local control of 95% and 85.9%; laryngeal preservation of 100% and 85.9%; disease free survival of 88.7% and 85.9% and overall survival of 94.1% and 94.8% respectively. VHI-10 data was available for 23/63 patients. During the last follow up visit VHI-10 ranged from 0 to 11 (median 6) in the laser group and 0 to 34 (median 7) in the radiation group.

Conclusion

T1b SCC of the glottis can be effectively treated with transoral laser microsurgery with oncological outcomes that are at least equivalent to radiation. For patients with VHI scores, voice quality was similar between the two groups. To our knowledge this is the first study directly comparing the oncologic and voice outcomes with laser and radiation for the treatment of glottic cancer involving the anterior commissure.

Keywords:
Anterior commissure; SCC; Glottis; Laser; Radiation