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An International Retrospective Study Comparing Chemoradiotherapy and Primary Surgery for T3 Laryngeal Cancers
Pietro Marrè1, Matteo Fermi2,3, Agata Degli Esposti2,3
1Department of Oto-Rhino-Laryngology-Head and Neck Surgery, AP-HM, La Conception University Hospital, Aix-Marseille University, Marseille, France.
Background:
Few studies have compared chemoradiotherapy with primary surgery for T3 laryngeal cancers.
Methods:
This retrospective study compared two parallel consecutive patient cohorts: one treated surgically at the Sant'Orsola Hospital (Bologna, Italy) and the other managed with chemoradiotherapy at the Conception Hospital (Marseille, France).
Results:
The study included 106 patients, 66 treated with chemoradiotherapy and 40 managed surgically. In Kaplan-Meier analysis, 2- and 5-year disease-free survival rates were 75% and 70% in the chemoradiotherapy group versus 85% at both time points in the surgery group (p = 0.22). Cox regression, adjusted for follow-up, age, sex, and cN stage, showed no significant differences in disease-free (p = 0.46), overall (p = 0.36), or disease-specific survival (p = 0.95). Tracheostomy dependence was higher after surgery (62.5% vs. 30.30%, p = 0.002), with no difference in gastrostomy dependence.
Conclusions:
Surgical and nonsurgical approaches achieved comparable oncologic outcomes with a lower rate of tracheostomy dependence in the nonsurgical group.
