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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(03): e348-e356
DOI: 10.1055/s-0041-1730304
Original Research

Definitive Radiotherapy versus Surgery for the Treatment of Verrucous Carcinoma of the Larynx: A National Cancer Database Study

Anvesh R. Kompelli 
1   Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
,
Michael H. Froehlich 
1   Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
,
Patrick F. Morgan 
1   Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
,
Hong Li
1   Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
,
Anand K. Sharma
1   Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
,
Cherie-Ann O. Nathan
2   Department of Otolaryngology - Head and Neck Surgery, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, United States
,
David M. Neskey
1   Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
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Abstract

Introduction Traditionally, larger lesions of laryngeal verrucous carcinoma are treated with surgical excision, with definitive radiotherapy generally reserved for smaller lesions. However, data utilizing modern databases is limited.

Objective The authors sought to assess, utilizing the National Cancer Database, whether overall survival for patients with laryngeal verrucous carcinoma was equivalent when treated with definitive radiotherapy versus definitive surgery.

Methods A retrospective cohort study was conducted utilizing the National Cancer Database. All cases of laryngeal verrucous carcinoma within the National Cancer Database between 2006 and 2014 were reviewed. Patients with T1–T3 (American Joint Commission on Cancer 7th Edition) laryngeal verrucous carcinoma were included and stratified by treatment modality. Demographics, treatment, and survival data were analyzed.

Results A total of 392 patients were included. Two hundred and fifty patients underwent surgery and 142 received radiotherapy. The two groups differed in age, transition of care, clinical T stage, and clinical stages. There was no significant difference in survival between T1–T3 lesions treated with surgery or radiotherapy (p = 0.32). Age, comorbidities, insurance status, and clinical T stage impacted overall hazard on multivariate analysis (p < 0.01). For patients treated with radiotherapy, age, insurance status, and clinical T stage were predictive of increased hazard.

Conclusion Overall survival is equivalent for patients with clinical T1 and clinical T2 laryngeal verrucous carcinoma treated with primary radiotherapy versus primary surgery. Thus, radiotherapy should be considered as a non-inferior treatment modality for certain patients with laryngeal verrucous carcinoma.

Keywords

verrucous carcinoma - laryngeal neoplasms - survival analysis - surgical oncology - radiotherapy


Publication History

Received: 18 May 2020

Accepted: 07 January 2021

Article published online:
03 November 2021

© 2021. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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