Surgery‐based versus radiation‐based treatment strategy for a high metabolic volume laryngeal cancer
Supported by a Grant‐in‐Aid for Young Scientists (B) (KAKENHI 15K20218) from the Japan Society for the Promotion of Science (JSPS). The authors have no other funding, financial relationships, or conflicts of interest to disclose.
Abstract
Objective/Hypothesis
We previously reported that the metabolic tumor volume (MTV) of a primary tumor was an independent prognostic factor for survival in laryngeal carcinoma treated by radiotherapy (RT)‐based protocol. The purpose of this study was to evaluate the difference in survival outcomes between surgery‐based and RT‐based treatment in patients with a MTV laryngeal cancer.
Study Design
An individual retrospective cohort study.
Methods
We reviewed the records of 63 patients with laryngeal cancer showing a primary tumor with a high MTV value (≥ 4.9 mL). The patients were separated into two groups by primary treatment strategy: 22 patients were included in the surgery group, and 41 patients were included in the RT group. Clinical factors and treatment modalities were analyzed for their association with survival.
Results
Multivariate analysis, including age, sex, subsite, T classification, nodal metastasis, and treatment modality, showed that the subsite (hazard ratio [HR] 2.55, P = 0.043) and treatment modality (HR 3.98, P = 0.019) were independent predictors for survival. The Kaplan‐Meier curves for 2‐year relapse‐free survival rates and overall survival rates for patients in the surgery and RT groups were 74.2% versus 38.8% (P = 0.025) and 80.1% versus 66.7% (P = 0.078).
Conclusions
Patients with a high metabolic volume laryngeal cancer treated by a surgery‐based protocol showed better relapse‐free survival and overall survival than did those undergoing RT‐based treatment. Pretreatment MTV assessment could be useful in planning the treatment strategy for patients with a laryngeal cancer.
Level of Evidence
2b. Laryngoscope, 127:862–867, 2017
