Radiological risk factors for T2-T3 glottic carcinoma treated with (chemo)radiotherapy-a multicenter analysis

Area of Science:

• Oncology
• Radiology
• Laryngology

Background:

• Organ-preserving surgery for T2-T3 glottic cancer is limited by high-risk tumor extension areas identified on preoperative imaging.
• The predictive value of these surgical high-risk zones for conservative treatments like (chemo)radiotherapy ((C)RT) is unclear.

Purpose of the Study:

• To evaluate the impact of predefined surgical high-risk zones on outcomes in patients with T2-T3 glottic carcinoma treated with primary (C)RT.
• To determine if radiological risk factors predictive in surgical cases also predict treatment failure in (C)RT-treated patients.

Main Methods:

• Retrospective analysis of 180 patients with T2-3, N0-3, M0 glottic carcinoma treated with primary (C)RT.
• Imaging was scored for tumor involvement of high-risk laryngeal areas.
• 5-year locoregional control (LRC) and disease-specific survival (DSS) were compared using log-rank test and Cox proportional hazards model.

Main Results:

• Vertical anterior commissure involvement significantly impacted LRC and DSS.
• Horizontal anterior commissure and anterior paraglottic space involvement reduced LRC.
• Deep vocal muscle infiltration showed negative trends; vertical anterior commissure infiltration trended toward lower DSS in multivariable analysis.

Conclusions:

• Anterior commissure involvement, especially vertical extension, predicts poorer outcomes in T2-T3 glottic carcinoma treated with (C)RT.
• Anterior paraglottic space involvement and tumor infiltration depth may also have predictive value.
• Findings support harmonized prognostic factors across treatment modalities for glottic cancer.