{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:36:33Z","timestamp":1787027793559,"version":"build-2736575974"},"reference-count":35,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005941","name":"Dietmar Hopp Stiftung","doi-asserted-by":"publisher","award":["23,011,184"],"award-info":[{"award-number":["23,011,184"]}],"id":[{"id":"10.13039\/501100005941","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Supraglottic laryngeal cancer is characterized by poor prognosis. In contrast, excellent outcomes have been published in early-stage supraglottic cancers after laser surgery in single-institutional series in centers of excellence. Are these results reproducible in the normal clinical practice of less specialized facilities? As part of an observational cohort study, the outcomes of 194 supraglottic cancer patients were assessed after treatment by larynx-preserving surgery (transoral laser microsurgery [TLM] or open partial laryngectomy [OPL]) or total laryngectomy (TL), with each having risk-adopted adjuvant treatment, or primary (chemo-)radiotherapy (pCRT or pRT). In early-stage supraglottic cancers, TLM achieved a 5-year overall survival (5-year OS) of 62.0%. No significant survival difference could be discerned between patients with and without adjuvant treatment (HR 1.47; 95% CI: 0.80 2.69). The comparison between pCRT and pRT patients suggests that CRT is more effective in supraglottic cancer. The 5-year OS rate achieved in our multiinstitutional setting is comparable to that reached in laser surgery centers of excellence (59.4\u201376.0%). According to our data and supported by the literature, adjuvant RT (aRT) is not sufficiently effective in supraglottic cancers. In case adjuvant therapy is indicated, adjuvant chemoradiation (aCRT) could be recommended.<\/jats:p>","DOI":"10.3390\/cancers13030568","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T05:44:42Z","timestamp":1612244682000},"page":"568","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["An Observational Cohort Study on 194 Supraglottic Cancer Patients: Implications for Laser Surgery and Adjuvant Treatment"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4316-4908","authenticated-orcid":false,"given":"Gerhard","family":"Dyckhoff","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2821-4361","authenticated-orcid":false,"given":"Rolf","family":"Warta","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1915-745X","authenticated-orcid":false,"given":"Christel","family":"Herold-Mende","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Rudolph","sequence":"additional","affiliation":[{"name":"Heidelberg Institute of Global Health, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter K.","family":"Plinkert","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heribert","family":"Ramroth","sequence":"additional","affiliation":[{"name":"Heidelberg Institute of Global Health, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1002\/ijc.31937","article-title":"Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods","volume":"144","author":"Ferlay","year":"2019","journal-title":"Int. J. Cancer"},{"key":"ref_2","unstructured":"(2020, October 16). Am Cancer Soc Key Statistics for Laryngeal and Hypopharyngeal Cancers. Available online: https:\/\/www.cancer.org\/content\/dam\/CRC\/PDF\/Public\/8664.00.pdf."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3233","DOI":"10.1007\/s00405-014-3100-9","article-title":"Long-term trends in gender, T-stage, subsite and treatment for laryngeal cancer at a single center","volume":"271","author":"Falk","year":"2014","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1002\/ijc.28388","article-title":"Progress against laryngeal cancer in The Netherlands between 1989 and 2010","volume":"134","author":"Coebergh","year":"2014","journal-title":"Int. J. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1055\/s-0038-1633906","article-title":"Interaction effects and population-attributable risks for smoking and alcohol on laryngeal cancer and its subsites. A case-control study from Germany","volume":"43","author":"Ramroth","year":"2004","journal-title":"Methods Inf. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1023\/A:1021944123914","article-title":"Combined effect of tobacco and alcohol on laryngeal cancer risk: A case-control study","volume":"13","author":"Talamini","year":"2002","journal-title":"Cancer Causes Control CCC"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1097\/CEJ.0b013e3282b6fd40","article-title":"Alcohol and laryngeal cancer: An update","volume":"17","author":"Zhang","year":"2008","journal-title":"Eur. J. Cancer Prev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1001\/archotol.134.4.370","article-title":"Five-year survival rates and time trends of laryngeal cancer in the US population","volume":"134","author":"Cosetti","year":"2008","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s40463-018-0262-2","article-title":"Treatment of early stage Supraglottic squamous cell carcinoma: Meta-analysis comparing primary surgery versus primary radiotherapy","volume":"47","author":"Patel","year":"2018","journal-title":"J. Otolaryngol. Head Neck Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s40463-018-0321-8","article-title":"Functional outcomes in early (T1\/T2) supraglottic cancer: A systematic review","volume":"47","author":"Patel","year":"2018","journal-title":"J. Otolaryngol. Head Neck Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1080\/00016489950180531","article-title":"Glottic and supraglottic laryngeal carcinoma: Differences in epidemiology, clinical characteristics and prognosis","volume":"119","author":"Raitiola","year":"1999","journal-title":"Acta Otolaryngol."},{"key":"ref_12","unstructured":"Pfister, D.G. (2020, December 06). NCCN Clinical Practice Guidelines in Oncology in Head and Neck Cancers (Version 2.2020). Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/head-and-neck.pdf."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1159\/000276258","article-title":"Supraglottic versus glottic laryngeal cancer: Epidemiological and pathological aspects","volume":"54","author":"Silvestri","year":"1992","journal-title":"Orl J. Oto-Rhino-Laryngol. Its Relat. Spec."},{"key":"ref_14","first-page":"481","article-title":"Results of transoral laser resection in T1-2 oropharyngeal, hypopharyngeal and laryngeal carcinomas","volume":"90","author":"Iro","year":"2011","journal-title":"Laryngo-Rhino-Otologie"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1002\/lary.1978.88.9.1399","article-title":"Transoral laryngeal surgery using the CO2 laser: Laboratory experiments and clinical experience","volume":"88","author":"Vaughan","year":"1978","journal-title":"Laryngoscope"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1002\/lary.1983.93.4.429","article-title":"Transoral partial supraglottic resection using the CO2 laser","volume":"93","author":"Davis","year":"1983","journal-title":"Laryngoscope"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1177\/000348949810700810","article-title":"Carbon dioxide laser microsurgery for early supraglottic carcinoma","volume":"107","author":"Ambrosch","year":"1998","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1001\/archotol.124.11.1245","article-title":"Transoral laser surgery of supraglottic cancer: Follow-up of 141 patients","volume":"124","author":"Iro","year":"1998","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1002\/hed.20811","article-title":"Transoral laser surgery for supraglottic cancer","volume":"30","author":"Rodrigo","year":"2008","journal-title":"Head Neck"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"158","DOI":"10.3389\/fonc.2018.00158","article-title":"Transoral Laser Microsurgery for Supraglottic Cancer","volume":"8","author":"Ambrosch","year":"2018","journal-title":"Front. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1177\/000348940411300210","article-title":"Endoscopic supraglottic laryngectomy with postoperative irradiation","volume":"113","author":"Davis","year":"2004","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1007\/s007610050054","article-title":"Stellenwert der Laserchirurgie bei Tumoren der oberen Luft-und Speisewege","volume":"2","author":"Steiner","year":"1996","journal-title":"Der. Onkol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1177\/000348949910800901","article-title":"Transoral carbon dioxide laser resection of supraglottic carcinoma","volume":"108","author":"Rudert","year":"1999","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1055\/s-2007-997084","article-title":"Special aspects of histopathologic diagnosis in laser microsurgery of cancers of the upper aerodigestive tract","volume":"73","author":"Ambrosch","year":"1994","journal-title":"Laryngo-Rhino-Otologie"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.oraloncology.2019.08.005","article-title":"Prognostic significance of surgical margins after transoral laser microsurgery for early-stage glottic squamous cell carcinoma","volume":"97","author":"Jumaily","year":"2019","journal-title":"Oral Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1177\/0194599819874315","article-title":"Margins in Laryngeal Squamous Cell Carcinoma Treated with Transoral Laser Microsurgery: A National Database Study","volume":"161","author":"Hanna","year":"2019","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.1007\/s00405-018-5027-z","article-title":"Oncological and functional outcomes of transoral laser surgery for laryngeal carcinoma","volume":"275","author":"Lopez","year":"2018","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3389\/fonc.2017.00245","article-title":"Impact of Close and Positive Margins in Transoral Laser Microsurgery for Tis-T2 Glottic Cancer","volume":"7","author":"Fiz","year":"2017","journal-title":"Front. Oncol."},{"key":"ref_29","unstructured":"Iro, H., Verse, T., Wollenberg, B., and Zenk, J. (2020). Chirurgische Onkologie, Halschirurgie. HNO Update 2020, Med Update."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1056\/NEJMoa032646","article-title":"Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck","volume":"350","author":"Cooper","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1056\/NEJMoa032641","article-title":"Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer","volume":"350","author":"Bernier","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1007\/s00405-009-1028-2","article-title":"Current trends in initial management of laryngeal cancer: The declining use of open surgery","volume":"266","author":"Silver","year":"2009","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Dyckhoff, G., Plinkert, P.K., and Ramroth, H. (2017). A change in the study evaluation paradigm reveals that larynx preservation compromises survival in T4 laryngeal cancer patients. BMC Cancer, 17.","DOI":"10.1186\/s12885-017-3608-7"},{"key":"ref_34","unstructured":"Allison, P. (2010). Survival Analysis Using SAS A Practical Guide, SAS Institute Inc.. [2nd ed.]."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Chronic Dis."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/3\/568\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:18:39Z","timestamp":1760159919000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/3\/568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,2]]},"references-count":35,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["cancers13030568"],"URL":"https:\/\/doi.org\/10.3390\/cancers13030568","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,2]]}}}