title: Retrospective analysis of therapeutic effect and prognostic factors on early glottic carcinoma.
abstract: OBJECTIVE
  To investigate the therapeutic effect of surgery, radiotherapy and photodynamic therapy on early glottic carcinoma and prognostic factors.
  
  
  METHODS
  Retrospective analysis of 202 cases with early glottic carcinoma (Tis-T2N0M0) underwent surgery (n=152), radiotherapy (n=20) and PDT (n=30) from 2000 to 2013 The KPS score, the disease-free survival (DFS), overall survival (OS), local control (LC), larynx preservation rate, laryngeal function were evaluated. The methods of χ (2)test or Fisher's exact probability method, Kaplan Meier method, log-rank test of Kaplan-Meier method, Cox proportional hazards model were used to analyze the data.
  
  
  RESULTS
  There was no statistical significance in OS, DFS and LC among the three groups. The laryngeal function preservation rate of RT group, PDT group and Surgery group were 90%, 86.7% and 65.1% respectively, with the former two groups significantly superior to Surgery group. While there is no statistical significance between RT group and PDT group. Single factor analysis showed that KPS score before treatment, vocal fold mobility limitation and differentiation degree could have an effect on prognosis. Multivariate regression analyses indicated that anterior commissure invasion, T stage and KPS score before treatment were independent adverse prognostic factors for OS. T stage and differentiation degree were adverse prognostic factors for DFS. T stage was also an adverse factor of LC. Thirty-three cases experienced local recurrence or cervical lymph node metastasis. Three groups showed no statistical difference in local recurrence or lymph node metastasis, with twenty-two cases in Surgery group, four in RT group and seven in PDT group.
  
  
  CONCLUSIONS
  The therapeutic effect was approximate in surgery group, radiotherapy group and photodynamic group, and all three treatment regimens achieved good clinical effect. Radiotherapy and photodynamic therapy may be the first or very important treatment on early stage glottic squamous cell cancer (Tis∼T2N0M0). However only 6 patients underwent PDT for T2 disease, making definitive treatment conclusions for this subgroup unclear.
authors.affiliation: Cancer Center, Southern Medical University, Guangzhou 510315, China; Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou 510315, China.
authors.forename: Zhongzhong
authors.initials: Z
authors.lastname: Peng
authors.affiliation: Department of Oncology, Jiujiang First Hospital, Jiujiang, China.
authors.forename: Yanbing
authors.initials: Y
authors.lastname: Li
authors.affiliation: Cancer Center, Southern Medical University, Guangzhou 510315, China; Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou 510315, China.
authors.forename: Longwei
authors.initials: L
authors.lastname: Jin
authors.affiliation: Department of Endoscopy, Cancer Center of Guangzhou Medical University, China.
authors.forename: Xiaopeng
authors.initials: X
authors.lastname: Tao
authors.affiliation: Cancer Center, Southern Medical University, Guangzhou 510315, China; Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou 510315, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Cai
authors.affiliation: The Third Hospital of Wenzhou Medical University, Ruian, Zhejiang 325200, China.
authors.forename: Jieni
authors.initials: J
authors.lastname: Feng
authors.affiliation: Cancer Center, Southern Medical University, Guangzhou 510315, China; Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou 510315, China.
authors.forename: Rengeng
authors.initials: R
authors.lastname: Liu
authors.affiliation: Cancer Center, Southern Medical University, Guangzhou 510315, China; Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou 510315, China.
authors.forename: Qianyu
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Cancer Center, Southern Medical University, Guangzhou 510315, China; Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou 510315, China. Electronic address: 945971900@qq.com.
authors.forename: Libo
authors.initials: L
authors.lastname: Li
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy / Q000401:mortality / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality* / Q000628:therapy*; D007825:Laryngectomy / Q000401:mortality* / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000401:mortality* / Q000706:statistics & numerical data; D015995:Prevalence; D011379:Prognosis; D011878:Radiotherapy / Q000401:mortality* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Early glottic carcinoma; Photodynamic therapy; Prognostic factors; Radiotherapy; Surgery