The impact of undergoing surgical margin evaluation during endoscopic surgery for early-stage laryngeal squamous cell carcinoma

Abstract

Background: The impact of evaluating versus not evaluating surgical margins for early-stage laryngeal squamous cell carcinoma (LSCC) has not been evaluated.

Methods: Overall survival was compared between patients who underwent endoscopic surgery for cT1-2, N0, M0 LSCC and had surgical margins evaluated versus not evaluated versus unevaluable in the National Cancer Database (2010-2019) using multivariable-adjusted Cox proportional hazards analyses.

Results: 7597 patients met study eligibility criteria. 4123 (54.3%) patients underwent margin evaluation, 1631 (21.5%) did not undergo margin evaluation, and 1843 (24.3%) had unevaluable margins. Patients undergoing margin evaluation had better overall survival than patients who did not undergo margin evaluation (HR: 0.88, 95% CI: 0.78-1.00, p = 0.044) and patients with unevaluable margins (HR: 0.88, 95% CI: 0.78-0.98, p = 0.021). Patients undergoing margin evaluation received significantly less adjuvant radiation.

Conclusions: Surgical margin evaluation is an important prognostic factor for patients receiving endoscopic surgery for early-stage LSCC and should be conducted whenever possible.

Keywords: LSCC; endoscopic surgery; laryngeal cancer; surgical margin evaluation; surgical margin status.