Analysis of prognostic factors, including the incidence of second primary cancer, in patients with early stage laryngeal squamous cell carcinoma treated by radiation-based therapy

Many patients with head and neck squamous cell carcinoma (HNSCC) are diagnosed at an advanced stage, whereas more than half of those with laryngeal cancer are diagnosed at an early stage (1,2). Early-stage laryngeal squamous cell carcinoma (ELSCC), particularly the most common form arising in the glottis, is known to be curable. It does matter whether the treatment for ELSCC aims at preserving laryngeal function or not. According to the National Comprehensive Cancer Network (NCCN) Guidelines, partial laryngectomy, such as transoral laser microsurgery (TLM) and partial laryngectomy, and radiation therapy (RT) were recommend as appropriate treatment modalities for ELSCC (3). Previous articles comparing these two modalities reported that the treatment outcomes were generally similar (4,5), whereas RT might afford better voice outcomes following treatment than TLM in patients with stage II cancer (5-7). In patients with residual or recurrence tumor, phonetic function is sacrificed in cases undergoing radical salvage surgery. Considering that the local control rate of stage II cancer remains unsatisfactory (8-11), we believe that the primary treatment strategy of stage II cancer needs to be enhanced