Exclusive surgery versus postoperative radiotherapy for supraglottic cancer.
OBJECTIVE
To verify the effectiveness of prophylactic postoperative radiotherapy for supraglottic cancer.


METHODS
97 patients underwent supraglottic horizontal laryngectomy with bilateral neck dissection: 35 patients (group A) received postoperative radiotherapy (60-70 Gy, 2 Gy fractions daily); 62 patients (group B) received only surgery.


RESULTS
Overall 5-year actuarial survival and corrected actuarial survival rates were 74 and 90% in group A and 61 and 80% in group B (p = 0.2 and 0.4, respectively). As for tumor extent, no significant differences were observed between the two groups. In N0 patients overall actuarial survival rate was significantly higher in group A as compared to group B (p = 0.01); most likely this difference was due to errors in clinical staging for the presence of reactive lymphadenitis and micrometastases.


CONCLUSIONS
The present study did not document the effectiveness of postoperative radiotherapy. Radiation therapy should be avoided in those patients in whom surgery was proven to be curative while it could be considered in combination with surgery when the resection margins are dubious and/or inadequate.
Esposito
Erik
E
ENT Department, Ospedale 'Santa Maria della Pietà', Nola, Rome.
Motta
Sergio
S
Motta
Gaeto
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000528:radiation effects* / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011182:Postoperative Care; D011829:Radiation Dosage