A comparative STROBE analysis of 10-year oncologic results of SCPL-CHEP and endoscopic CO2 laser cordectomy for cT2N0M0 glottic squamous cell carcinoma.

OBJECTIVE

To compare 10-year oncologic results of supracricoid partial laryngectomy and cricohyoidoepiglottopexy (SCPL-CHEP) versus CO2 laser cordectomy (LC) for cT2N0M0 glottic squamous cell carcinoma (SCC).

MATERIAL AND METHOD: Retrospective observational analysis of an inception cohort of 57 patients with isolated cT2N0M0 glottic SCC consecutively managed at a French university teaching otorhinolaryngology department during the years 1993-2013: 33 with SCPL-CHEP and 24 with LC. In all, 93% and 81% of patients were followed for respectively at least 5 years, or 10 years or until death. The main endpoint was 10-year actuarial overall and disease-free survival. Secondary endpoints comprised cause of death, 10-year actuarial local control, and 10-year laryngeal preservation estimates.

RESULTS

Ten-year survival was 58% whichever the surgical technique. Ten-year disease-free survival was 87% after SCPL-CHEP and 71% after LC (P=0.15). Death related to SCC occurred in 3 patients after LC but was not encountered after SCPL-CHEP. Ten-year local control differed: 100% after SCPL-CHEP versus 65% after LC, with 96% overall local control after salvage treatment. Ten-year laryngeal preservation differed: 97% after SCPL-CHEP versus 74% after LC (P=0.03).

CONCLUSIONS

In patients with cT2N0M0 glottic SCC considered amenable to partial laryngeal surgery, the present long-term data should lead head and neck surgeons to discuss the benefits and pitfalls of both LC and SCPL-CHEP.