The DAHANCA 27 Phase II Study: Transoral Laser Microsurgery for T1aN0M0 Glottic Squamous Cell Carcinoma, a Comparison to Accelerated Radiotherapy.

Abstract

Endoscopic surgery of T1a glottic squamous cell carcinoma (SCC) is believed to have advantages compared to radiotherapy (RT), including short duration, cost-effectiveness, repeatability, and RT reserved for second tumors/failures. The equality of tumor control probability after treatments is unresolved. In the DAHANCA 27 phase II study, selected Danish patients suspected of T1a glottic SCC between 2012 and 2016 were offered one-step diagnostic and curatively intended transoral laser microsurgery (TLM). The 5-year outcome was compared to a 2003-2012 national cohort of T1a glottic SCC patients treated with accelerated RT (accRT). The TLM (n = 94) treatment included cordectomy type I (n = 44), II (n = 38), and III (n = 12). Failure was observed in 10/94 TLM and 36/534 accRT patients, resulting in 1 and 23 laryngectomies, respectively. The 5-year laryngectomy-free disease-specific survival was TLM 97.9% and accRT 94.6%, HR: 0.37 (0.09, 1.54). Primary TLM for selected T1a glottic SCC patients is an organ preserving treatment with high disease control comparable to accRT.