A STROBE analysis of conservative laryngeal treatment in France for cT1-2N0M0 glottic squamous cell carcinoma in octogenarians.

Objectives: To document conservative laryngeal treatment for cT12N0M0 glottic squamous cell carcinoma (SCC) in octogenarians in France in the 21st century.

Material And Methods: Retrospective observational study comparing a cohort of 38 octogenarians (Group A) to a control cohort of 107 septuagenarians (Group B), with isolated cT12N0M0 glottic SCC, consecutively managed between 2000 and 2018 at a single French university hospital center. The main endpoints were 5-year actuarial overall and disease-free survival and causes of death, compared between groups. Accessory endpoints were 5-year actuarial local control and laryngeal preservation. 93% of patients were followed until death or for a minimum 5years. The STROBE guideline was used. The significance threshold was set at P<0.005.

Results: The only significant difference in demographic, oncologic and treatment variables between groups was a higher mean Charlson index in Group A (P=0.004). Five-year actuarial survival, at 79% overall, did not significantly differ between groups A and B (80% and 79%, respectively; P=0.30). Five-year actuarial disease-free survival, at 74% overall, did not significantly differ between groups (77% and 73%; P=0.42). Intercurrent disease accounted for 44% of causes of death, with cardiovascular etiology in 71% of cases. Five-year actuarial local control, at 76% overall, did not significantly differ between groups (80% and 75%; P=0.41). Salvage treatment for local recurrence yielded a 94% overall local control rate: 98% in Group A and 93% in Group B. Five-year actuarial laryngeal preservation rate, at 92%, did not significantly differ between groups (90% and 98%; P=0.20).

Conclusion: Conservative laryngeal treatment for cT12N0M0 SCC in octogenarians yielded the same results as in septuagenarians. Improvement in survival will depend on management and monitoring of comorbidity, and particularly cardiovascular comorbidity.