title: Survival differences between organ preservation surgery and definitive radiotherapy in early supraglottic squamous cell carcinoma.
abstract: OBJECTIVE
  Single-modality treatment, either with organ preservation surgery (OPS) or definitive radiation (RT), is the treatment of choice for patients with early supraglottic squamous cell carcinoma (SGC). However, studies comparing the effectiveness of these 2 techniques are lacking. This study compares the survival outcomes in early SGC patients treated with OPS versus RT.
  
  
  METHODS
  Secondary data analysis.
  
  
  METHODS
  Surveillance, Epidemiology and End Results database.
  
  
  METHODS
  This study included adult patients with early-stage (T1N0, T2N0) SGC undergoing single-modality treatment with either OPS (with or without neck dissection [ND]) or RT between 1988 and 2008. Survival analysis was used to compare the overall survival (OS) and disease-specific survival (DSS) between patients treated with OPS+ND, OPS alone, and RT.
  
  
  RESULTS
  A total of 2631 T1/T2 N0 SGC patients were identified, of whom 167 (6%) were treated with OPS+ND, 186 (7%) with OPS only, and 2278 patients (87%) with definitive RT only. In stage I (T1N0) SGC patients, a significantly better 5-year DSS was noted for both OPS+ND (81% vs 68%, hazard ratio [HR] = 0.61, P = .03) and OPS only (82% vs 68%, HR = 0.70, P = .05) when compared with definitive RT. For stage II (T2N0) patients, only OPS+ND resulted in a significantly better 5-year DSS (86% vs 60%, HR = 0.31, P < .001) when compared with patients treated with RT.
  
  
  CONCLUSIONS
  Patients with early SGC who underwent OPS+ND had better OS and DSS than patients undergoing RT alone. OPS+ND may be considered a viable and preferred treatment option in these patients.
authors.affiliation: Department of Head and Neck/Plastic and Reconstructive Surgery, Roswell Park Cancer Institute, Buffalo, New York, USA.
authors.forename: Hassan
authors.initials: H
authors.lastname: Arshad
authors.forename: Vijayvel
authors.initials: V
authors.lastname: Jayaprakash
authors.forename: Vishal
authors.initials: V
authors.lastname: Gupta
authors.forename: David M
authors.initials: DM
authors.lastname: Cohan
authors.forename: Dildeep
authors.initials: D
authors.lastname: Ambujakshan
authors.forename: Nestor R
authors.initials: NR
authors.lastname: Rigual
authors.forename: Anurag K
authors.initials: AK
authors.lastname: Singh
authors.forename: Wesley L
authors.initials: WL
authors.lastname: Hicks
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D005931:Glottis; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: definitive radiotherapy; disease-specific survival; organ preservation surgery; over survival; supraglottic squamous cell carcinoma