A STROBE analysis of conservative laryngeal treatment in France for cT1-2N0M0 glottic squamous cell carcinoma in octogenarians.

OBJECTIVES

To document conservative laryngeal treatment for cT12N0M0 glottic squamous cell carcinoma (SCC) in octogenarians in France in the 21st century.

MATERIAL AND

METHODS

Retrospective observational study comparing a cohort of 38 octogenarians (Group A) to a control cohort of 107 septuagenarians (Group B), with isolated cT12N0M0 glottic SCC, consecutively managed between 2000 and 2018 at a single French university hospital center. The main endpoints were 5-year actuarial overall and disease-free survival and causes of death, compared between groups. Accessory endpoints were 5-year actuarial local control and laryngeal preservation. 93% of patients were followed until death or for a minimum 5years. The STROBE guideline was used. The significance threshold was set at P<0.005.

RESULTS

The only significant difference in demographic, oncologic and treatment variables between groups was a higher mean Charlson index in Group A (P=0.004). Five-year actuarial survival, at 79% overall, did not significantly differ between groups A and B (80% and 79%, respectively; P=0.30). Five-year actuarial disease-free survival, at 74% overall, did not significantly differ between groups (77% and 73%; P=0.42). Intercurrent disease accounted for 44% of causes of death, with cardiovascular etiology in 71% of cases. Five-year actuarial local control, at 76% overall, did not significantly differ between groups (80% and 75%; P=0.41). Salvage treatment for local recurrence yielded a 94% overall local control rate: 98% in Group A and 93% in Group B. Five-year actuarial laryngeal preservation rate, at 92%, did not significantly differ between groups (90% and 98%; P=0.20).

CONCLUSION

Conservative laryngeal treatment for cT12N0M0 SCC in octogenarians yielded the same results as in septuagenarians. Improvement in survival will depend on management and monitoring of comorbidity, and particularly cardiovascular comorbidity.