title: Evaluating organ preservation outcome as treatment endpoint for T1aN0 glottic cancer.
abstract: Common endpoints in reporting the outcomes for early glottic cancer do not highlight the importance of organ preservation. We evaluated the treatment outcomes among patients with T1aN0 laryngeal cancer with laryngectomy-free disease-specific survival (LFS-DSS), which is defined as time to total laryngectomy or time to death from cancer cause, against all other endpoints.
  
  
  
  Outcome research on an institutional database.
  
  
  
  A retrospective review covered all consecutive patients from 2003 to 2013. Patients with T1a laryngeal squamous cell carcinoma (SCC) were offered the options of either radiation treatment (RT) or transoral laser microsurgery (TLM). Tumor control, survival outcomes, standard definition laryngectomy-free survival (LFS), and LFS-DSS were calculated.
  
  
  
  There were 105 patients, of whom 53 were treated with TLM and 52 were treated with RT. There were 11 recurrences within the TLM group, of which four were successfully salvaged with repeated TLM and two were salvaged with RT. Among the four recurrences within the RT group, all four patients had salvage total laryngectomies. The 5-year overall survival for patients treated with TLM versus RT was 86% versus 85% (P = .887), disease-free survival was 69% versus 78% (P = .151), LFS was 65% versus 77% (P = .198), LFS-DSS was 100% versus 88% (P = .030), and ultimate locoregional control was 100% in both groups.
  
  
  
  Patients with T1aN0 glottic SCC treated with RT or TLM have similar survival outcomes. Patients with T1a tumor treated with TLM have better organ preservation compared to RT, when measured with LFS-DSS.
  
  
  
  4. Laryngoscope, 127:1322-1327, 2017.
authors: Department of Head and Neck Surgery, Chris O'Brien Lifehouse/Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.|Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia.
authors: Tsu-Hui Hubert
authors: TH
authors: Low
authors: Department of Otolaryngology, Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors: David
authors: D
authors: Yeh
authors: Division of Radiation Oncology, Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors: Tina
authors: T
authors: Zhang
authors: Department of Otolaryngology, Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors: Rakhna
authors: R
authors: Araslanova
authors: Division of Radiation Oncology, Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors: J Alex
authors: JA
authors: Hammond
authors: Division of Radiation Oncology, Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors: David
authors: D
authors: Palma
authors: Division of Radiation Oncology, Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors: Nancy
authors: N
authors: Read
authors: Division of Radiation Oncology, Department of Oncology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors: Varagur
authors: V
authors: Venkatesan
authors: Department of Otolaryngology, Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors: S Danielle
authors: SD
authors: MacNeil
authors: Department of Otolaryngology, Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors: John
authors: J
authors: Yoo
authors: Department of Otolaryngology, Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors: Anthony
authors: A
authors: Nichols
authors: Department of Otolaryngology, Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors: Kevin
authors: K
authors: Fung
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005931:Glottis / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D007825:Laryngectomy / Q000379:methods; D053685:Laser Therapy / Q000379:methods; D008297:Male; D008562:Membrane Glycoproteins; D008565:Membrane Proteins; D008866:Microsurgery / Q000379:methods / Q000401:mortality*; D008875:Middle Aged; D009055:Mouth / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000601:surgery; D059351:Organ Sparing Treatments / Q000379:methods / Q000401:mortality*; D011878:Radiotherapy / Q000379:methods / Q000401:mortality; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome; D000098853:Podoplanin
chemical_list: D008562:Membrane Glycoproteins; D008565:Membrane Proteins; C117468:PDPN protein, human; D000098853:Podoplanin
keywords: Transoral laser microsurgery; early glottic cancer; head and neck cancer; laryngeal surgery; radiotherapy