Surgery versus radiotherapy for older patients (aged≥65 years) with stage I-II laryngeal cancer: an investigational study from the SEER database

Currently, the choice between radiotherapy and surgery for treating older patients with early laryngeal cancer remains unclear. The aim of this retrospective study is to investigate the therapeutic patterns and survival outcomes for a cohort of older patients with early laryngeal cancer who received radiation therapy (RT) or surgery. Clinical records of 1833 patients aged 65+ with stage I/II laryngeal cancer from the SEER registry (2010-2015) were assessed. Of these, 1319 underwent RT and 514 had surgery alone. Kaplan-Meier analysis assessed overall survival (OS) and cancer-specific survival (CSS), with Log-rank tests for comparison. The 5-year OS and CSS rates were 61.1% and 80.6%, respectively. Univariate analysis showed age, gender, T stage, histology, and treatment as prognostic factors for OS and CSS. Multivariate analysis linked age, T stage, and treatment to OS, and gender, histology, T stage, and treatment to CSS. Surgery improved OS and CSS for most early-stage patients, except those with grade III cancer. Among early-stage laryngeal cancer patients aged 65 years or older reported in the SEER database, those treated with surgery experienced longer OS and CSS compared to those treated with RT, except for patients with grade III.