TY - JOUR
T1 - Definitive Radiotherapy versus Surgery for the Treatment of Verrucous Carcinoma of the Larynx
T2 - A National Cancer Database Study
AU - Kompelli, Anvesh R.
AU - Froehlich, Michael H.
AU - Morgan, Patrick F.
AU - Li, Hong
AU - Sharma, Anand K.
AU - Nathan, Cherie Ann O.
AU - Neskey, David M.
N1 - Publisher Copyright:
© 2021. Fundação Otorrinolaringologia. All rights reserved.
PY - 2022/7
Y1 - 2022/7
N2 - Introduction Traditionally, larger lesions of laryngeal verrucous carcinoma are treated with surgical excision, with definitive radiotherapy generally reserved for smaller lesions. However, data utilizing modern databases is limited. Objective The authors sought to assess, utilizing the National Cancer Database, whether overall survival for patients with laryngeal verrucous carcinoma was equivalent when treated with definitive radiotherapy versus definitive surgery. Methods A retrospective cohort study was conducted utilizing the National Cancer Database. All cases of laryngeal verrucous carcinoma within the National Cancer Database between 2006 and 2014 were reviewed. Patients with T1–T3 (American Joint Commission on Cancer 7th Edition) laryngeal verrucous carcinoma were included and stratified by treatment modality. Demographics, treatment, and survival data were analyzed. Results A total of 392 patients were included. Two hundred and fifty patients underwent surgery and 142 received radiotherapy. The two groups differed in age, transition of care, clinical T stage, and clinical stages. There was no significant difference in survival between T1–T3 lesions treated with surgery or radiotherapy (p ¼ 0.32). Age, comorbidities, insurance status, and clinical T stage impacted overall hazard on multivariate analysis (p < 0.01). For patients treated with radiotherapy, age, insurance status, and clinical T stage were predictive of increased hazard. Conclusion Overall survival is equivalent for patients with clinical T1 and clinical T2 laryngeal verrucous carcinoma treated with primary radiotherapy versus primary surgery. Thus, radiotherapy should be considered as a non-inferior treatment modality for certain patients with laryngeal verrucous carcinoma.
AB - Introduction Traditionally, larger lesions of laryngeal verrucous carcinoma are treated with surgical excision, with definitive radiotherapy generally reserved for smaller lesions. However, data utilizing modern databases is limited. Objective The authors sought to assess, utilizing the National Cancer Database, whether overall survival for patients with laryngeal verrucous carcinoma was equivalent when treated with definitive radiotherapy versus definitive surgery. Methods A retrospective cohort study was conducted utilizing the National Cancer Database. All cases of laryngeal verrucous carcinoma within the National Cancer Database between 2006 and 2014 were reviewed. Patients with T1–T3 (American Joint Commission on Cancer 7th Edition) laryngeal verrucous carcinoma were included and stratified by treatment modality. Demographics, treatment, and survival data were analyzed. Results A total of 392 patients were included. Two hundred and fifty patients underwent surgery and 142 received radiotherapy. The two groups differed in age, transition of care, clinical T stage, and clinical stages. There was no significant difference in survival between T1–T3 lesions treated with surgery or radiotherapy (p ¼ 0.32). Age, comorbidities, insurance status, and clinical T stage impacted overall hazard on multivariate analysis (p < 0.01). For patients treated with radiotherapy, age, insurance status, and clinical T stage were predictive of increased hazard. Conclusion Overall survival is equivalent for patients with clinical T1 and clinical T2 laryngeal verrucous carcinoma treated with primary radiotherapy versus primary surgery. Thus, radiotherapy should be considered as a non-inferior treatment modality for certain patients with laryngeal verrucous carcinoma.
KW - laryngeal neoplasms
KW - radiotherapy
KW - surgical oncology
KW - survival analysis
KW - verrucous carcinoma
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U2 - 10.1055/s-0041-1730304
DO - 10.1055/s-0041-1730304
M3 - Article
AN - SCOPUS:85135227526
SN - 1809-9777
VL - 26
SP - E348-E356
JO - International Archives of Otorhinolaryngology
JF - International Archives of Otorhinolaryngology
IS - 3
ER -