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Surgery versus radiation for T1 glottic carcinoma: Second primary considerations
Sidharth V Puram1,2, Neil Bhattacharyya3
1Department of Otolaryngology, Washington University School of Medicine, St. Louis, Missouri.
The Laryngoscope
|February 16, 2019
Summary
This study found that the risk of developing a second laryngeal cancer is similar for patients treated with surgery or radiation therapy (RT) for early glottic carcinoma. Treatment choice does not appear to significantly impact the likelihood of a new laryngeal primary cancer.
Area of Science:
- Oncology
- Otolaryngology
- Radiation Oncology
Background:
- Early glottic carcinoma is typically managed with either radiation therapy (RT) or surgery.
- Limited data exists comparing the incidence of second primary laryngeal cancers after these treatment modalities.
Purpose of the Study:
- To compare the incidence and risk of second primary laryngeal malignancies in patients with T1 glottic carcinoma treated with surgery versus RT.
- To inform treatment algorithm development for early glottic squamous cell carcinoma.
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database for T1 glottic carcinoma cases.
- Compared cumulative hazard for second primary laryngeal malignancies using the log-rank method.
- Analyzed observed-to-expected incidence ratios and relative increased risk.
Main Results:
- Among 844 surgical and 2,272 RT cases, observed-to-expected incidence ratios for second primary laryngeal cancers were 10.19 (surgery) and 6.87 (RT) per 10,000 person-years.
- Relative increased risk was 20.95 (surgery) vs. 14.09 (RT) per 10,000 person-years.
- Mean time to development of a second primary was comparable (304 vs. 305 months).
Conclusions:
- Second laryngeal primary development is analogous between patients treated with surgery alone versus RT for early glottic carcinoma.
- These findings should be considered alongside voice and survival outcomes when discussing treatment options.
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