Treatment Outcomes in Patients with Carcinoma In Situ of the Larynx.

Abstract

To compare survival endpoints in patients with laryngeal carcinoma in situ (L-CIS) who received definitive radiotherapy (RT) versus other modalities as first-line treatment and after disease recurrence. This is a retrospective study of patients with L-CIS treated between June 2001 and December 2021. Survival outcomes (recurrence-free (RFS), invasion-free (IFS), laryngectomy-free (LFS), and overall survival (OS)) were compared between patients who had first-line RT versus non-RT modalities and for patients with recurrent disease who underwent second-line RT. A total of 85 patients with L-CIS were included (73 men [85.9%] and 12 [14.1%] women, median age of 65 [IQR: 55-74] years). Of these, 42 had first-line RT (49.4%) and 43 (50.6%) had non-RT treatment. After median follow-up of 4.8 (IQR: 2.8-9) years, patients in the first-line RT group had improved 2-year (94.2% [95% confidence interval (CI): 86.7-100] versus 41.7% [CI: 29.3-59.5]) and 5-year (90.6% [CI: 80.9-100] versus 27.5% [CI: 16.4-48.2]) RFS relative to non-RT recipients (p < 0.001). OS and IFS were similar between groups. However, patients in the RT group had worse 2-year (94% [CI: 87-100] versus 98% [CI: 93-100]) and 5-year (82% [CI: 68-99] versus 98% [CI: 93-100]; p = 0.013) LFS. All 35 patients with recurrent L-CIS were successfully cured with second-line treatments (12 received RT [34.3%]), and no differences in any survival endpoints were seen in these patients based on first-line and second-line treatments. Although first-line RT for L-CIS led to improved recurrence-free survival compared with other modalities, second-line RT may be a particularly valuable option for recurrent CIS. 3 Laryngoscope, 135:779-786, 2025.