An International Retrospective Study Comparing Chemoradiotherapy and Primary Surgery for T3 Laryngeal Cancers.

Abstract

Few studies have compared chemoradiotherapy with primary surgery for T3 laryngeal cancers. This retrospective study compared two parallel consecutive patient cohorts: one treated surgically at the Sant'Orsola Hospital (Bologna, Italy) and the other managed with chemoradiotherapy at the Conception Hospital (Marseille, France). The study included 106 patients, 66 treated with chemoradiotherapy and 40 managed surgically. In Kaplan-Meier analysis, 2- and 5-year disease-free survival rates were 75% and 70% in the chemoradiotherapy group versus 85% at both time points in the surgery group (p = 0.22). Cox regression, adjusted for follow-up, age, sex, and cN stage, showed no significant differences in disease-free (p = 0.46), overall (p = 0.36), or disease-specific survival (p = 0.95). Tracheostomy dependence was higher after surgery (62.5% vs. 30.30%, p = 0.002), with no difference in gastrostomy dependence. Surgical and nonsurgical approaches achieved comparable oncologic outcomes with a lower rate of tracheostomy dependence in the nonsurgical group.