Oncologic parity in T2 laryngeal cancer: transoral laser surgery and open partial laryngectomy.

[OBJECTIVE] The optimal surgical treatment for T2 laryngeal cancer remains controversial, with both open partial laryngectomy (OPL) and transoral laser microsurgery (TLM) being widely used. This study aims to compare the oncological outcomes of OPL and TLM in patients with T2 laryngeal cancer and identify factors influencing prognosis.

[METHODS] Data from 216 patients with T2 laryngeal cancer treated between 2012 and 2022 were retrospectively analyzed. Propensity score matching (PSM) was used to balance covariates between groups. Oncological outcomes were evaluated using overall survival (OS), disease-specific survival (DSS), and local recurrence-free survival (LRFS). Univariate and multivariate Cox regression analyses identified independent risk factors.

[RESULTS] A total of 168 patients underwent OPL and 48 underwent TLM. After PSM, 53 OPL and 26 TLM patients were matched. Significant differences in smoking history, drinking history, and tumor characteristics were diminished post-PSM. No significant differences in OS, DSS, or LRFS were observed between OPL and TLM, both before and after PSM. Multivariate analysis identified age > 65 years, female gender, impaired vocal cord mobility, and low differentiation as significant predictors of OS. Additionally, age > 65 years was associated with DSS and LRFS. After PSM, age > 65 years and female gender remained significant predictors of OS. Drinking history was associated with DSS, and female gender was associated with LRFS.

[CONCLUSION] Given TLM's functional advantages and similar oncological outcomes with OPL, it is recommended as the first-line treatment for T2 glottic and supraglottic carcinoma.