T1 squamous cell carcinoma of the glottis with anterior commissure involvement: Radiotherapy versus transoral laser microsurgery

Background: The optimal treatment method of T1 glottic squamous cell carcinoma (SCC) with involvement of the anterior commissure is still debatable. We compared the outcomes of radiotherapy (RT) and transoral laser microsurgery (TLM). Methods: Data were retrospectively collected for 54 patients who were treated by RT (n = 38) or TLM (n = 16) from 2006 to 2013. Results: No between-group differences were found in demographic or risk factors. Recurrence was noted in 6 patients of the TLM group and 5 of the RT group. There was a near-significant association of TLM with recurrence (p =.053). Radiation was associated with a higher 5-year disease-free survival (DFS) (87.3% vs 74.9%; p =.037). Both groups had excellent rates for local control (75% and 97%, respectively), and overall survival (78.9 and 87.5%, respectively). There were no significant differences in outcome parameters by tumor classification. Conclusion: TLM is associated with higher recurrence rates and lower DFS. Both patients with T1a and T1b disease had the same outcome parameters.