Comparison between radiotherapy and transoral laser microsurgery treatments in early-stages of glottis cancer: A five-year follow-up study

This study was aimed to compare the recurrence-free survival rate among patients with Stage I or II of squamous carcinoma of the glottis treated with transoral laser microsurgery or radiotherapy, at a Spanish tertiary hospital. Between January 2004 and December 2016, data were collected from 120 patients diagnosed with stages I or II of squamous cell carcinoma of the larynx located in the glottis. Ninety-one patients were treated with transoral laser microsurgery and 29 patients received radiotherapy. The recurrence-free survival was studied during the first five years after the primary treatment. Kaplan-Meier survival curves and Cox regression models were performed. The cumulative incidence of glottis cancer recurrence was 62.6% in those treated with transoral laser microsurgery and 65.5% in those treated with radiotherapy. This led to an absolute risk reduction of 2.9% (95% CI: -17.1 to 22.8), and a number needed to treat of 35 patients. Those patients who received transoral laser microsurgery had a 17% lower risk of recurrence of glottis cancer than those treated with radiotherapy (hazard ratio, HR = 0.83; 95% CI 0.42 to 1.64; Cohen’s d = 0.65). In the initial stages of glottis squamous cell carcinoma, treatment with transoral laser microsurgery shows a tendency for higher re¬currence-free survival than treatment with radical radiotherapy in the first five years of intervention. Patients were not assigned randomly to the treatment, which might influence the generalization of our findings.