Bilateral Neck Dissection Effectively Improves Prognosis of Patients With T3N0M0 Glottic Carcinoma

To evaluate the effect of bilateral elective node dissection on the prognosis of patients with T3N0M0 glottic carcinoma.

This retrospective cohort study enrolled two cohorts: patients screened from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute, and those treated at the First Affiliated Hospital of Sun Yat-sen University. Patients screened from the SEER database were divided into untreated, radiotherapy (RT), surgery, and concurrent systemic therapy (ST)/RT groups. Patients from our center were divided into unilateral and bilateral groups based on lymph node dissection. Propensity score-matching (PSM) was applied to eliminate baseline variations. Kaplan-Meier analysis was used to assess different treatment method effects.

This study retrieved 2027 and 133 patients from the SEER database and our center, respectively, from 2014 to 2022. After PSM, overall survival (OS) and cancer-specific survival (CSS) improved in the ST/RT (both p < 0.001) and surgery (both p < 0.001) groups versus the RT group, with no differences between groups (OS, p = 0.45; CSS, p = 0.84). Patients who underwent elective node dissection (END) had better OS (p = 0.025) and CSS (p < 0.001) than those without END. No significant difference was observed in OS (p = 0.110) between the END and ST/RT groups; however, the END group showed significant improvement in CSS (p = 0.007). Patients who underwent bilateral neck dissection had better progression-free survival than the unilateral group after PSM (p = 0.024).

Surgery combined with bilateral node dissection can bring better survival prognosis for patients with T3N0M0 glottic carcinoma.