Prognostic impact of initial treatment in surgically salvaged recurrences of early glottic cancer

OBJECTIVE: The purpose of this study was to analyze the outcomes of surgically salvaged early glottic cancer (EGC) recurrences after initial radiotherapy (RT) or transoral laser microsurgery (TLM). METHODS: A matched pair analysis by recurrent tumor-node-metastasis stage (rTNM) considering 27 patients who had TLM as initial treatment and 54 patients who failed after primary RT was performed. Post-recurrence overall and disease-specific survival (DSS) were evaluated. RESULTS: The RT-failed group showed worse post-recurrence overall survival (P < .001) and DSS (P = .005) compared to TLM-first group despite the same rTNM stage. The RT failed patients also showed more postoperative complications (longer mean decannulation time, P = .005; nasogastric feeding tube dependence, P = .012) and a higher rate of second locoregional recurrences (P = .004). CONCLUSION: The RT-failed EGC showed worse outcomes in terms of survival, complications, and locoregional recurrences compared to same recurrent TNM stage TLM-failed cases. LEVEL OF EVIDENCE: 3 Laryngoscope, 129:2328-2333, 2019.