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Exclusive surgery versus postoperative radiotherapy for supraglottic cancer
Erik Esposito1, Sergio Motta, Gaeto Motta
1ENT Department, Ospedale 'Santa Maria della Pietà', Nola, Rome.
Aim Of The Study:
To verify the effectiveness of prophylactic postoperative radiotherapy for supraglottic cancer.
Patients And Methods:
97 patients underwent supraglottic horizontal laryngectomy with bilateral neck dissection: 35 patients (group A) received postoperative radiotherapy (60-70 Gy, 2 Gy fractions daily); 62 patients (group B) received only surgery.
Results:
Overall 5-year actuarial survival and corrected actuarial survival rates were 74 and 90% in group A and 61 and 80% in group B (p = 0.2 and 0.4, respectively). As for tumor extent, no significant differences were observed between the two groups. In N0 patients overall actuarial survival rate was significantly higher in group A as compared to group B (p = 0.01); most likely this difference was due to errors in clinical staging for the presence of reactive lymphadenitis and micrometastases.
Conclusions:
The present study did not document the effectiveness of postoperative radiotherapy. Radiation therapy should be avoided in those patients in whom surgery was proven to be curative while it could be considered in combination with surgery when the resection margins are dubious and/or inadequate.