title: Diversity of treatment of T2N0 glottic cancer of the larynx: lessons to learn from epidemiological cancer registry data.
abstract: CONCLUSIONS
  Neither elective selective neck dissection nor any conservative treatment option in pT2cN0 glottic cancer showed a significant advantage on survival. This should be the basis for future treatment standardization. Obligatory documentation of the R status and cause of death in the cancer registries will improve the data interpretation in the future.
  
  
  OBJECTIVE
  Optimal adjuvant treatment of pT2cN0 glottic cancer is not well defined. The impact of neck dissection or radio(chemo)therapy for better outcome is unknown.
  
  
  METHODS
  In a retrospective cancer registry study we analyzed the survival of 73 patients with pT2cN0 glottic cancer in Thuringia, Germany, treated surgically between 1996 and 2005.
  
  
  RESULTS
  In all, 35 patients had undergone elective neck dissection, the remaining 38 patients had not. Histopathology revealed occult lymph node metastasis in three patients. Adjuvant radiotherapy was delivered to 17 patients and radiochemotherapy to 4. Overall, 52 patients received an adjuvant treatment. The 5-year recurrence-free survival rate was 60.8% and the 5-year overall survival rate was 56.5%. Multivariate but not univariate analysis revealed age >62 years (p = 0.05) and neck dissection (p = 0.033) as significant negative risk factors for tumor recurrence. Looking at overall survival, the site of primary surgery and radiotherapy were significant univariate risk factors, whereas multivariate analysis did not reveal any independent risk factor. No adjuvant treatment or combinations of adjuvant treatment resulted in better recurrence-free or overall survival (p = 0.253; p = 0.279).
authors.affiliation: Department of Otorhinolaryngology, University Hospital, Friedrich-Schiller-University Jena, Jena, Germany.
authors.forename: Mira
authors.initials: M
authors.lastname: Pantel
authors.forename: Claus
authors.initials: C
authors.lastname: Wittekindt
authors.forename: Annelore
authors.initials: A
authors.lastname: Altendorf-Hofmann
authors.forename: Daniel
authors.initials: D
authors.lastname: Boeger
authors.forename: Jens
authors.initials: J
authors.lastname: Buentzel
authors.forename: Dirk
authors.initials: D
authors.lastname: Esser
authors.forename: Andreas
authors.initials: A
authors.lastname: Mueller
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Wendt
authors.forename: Orlando
authors.initials: O
authors.lastname: Guntinas-Lichius
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis