Abstract
BACKGROUND: To evaluate the effect of bilateral elective node dissection on the prognosis of patients with T3N0M0 glottic carcinoma. METHODS: This retrospective cohort study enrolled two cohorts: patients screened from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute, and those treated at the First Affiliated Hospital of Sun Yat-sen University. Patients screened from the SEER database were divided into untreated, radiotherapy (RT), surgery, and concurrent systemic therapy (ST)/RT groups. Patients from our center were divided into unilateral and bilateral groups based on lymph node dissection. Propensity score-matching (PSM) was applied to eliminate baseline variations. Kaplan-Meier analysis was used to assess different treatment method effects. RESULTS: This study retrieved 2027 and 133 patients from the SEER database and our center, respectively, from 2014 to 2022. After PSM, overall survival (OS) and cancer-specific survival (CSS) improved in the ST/RT (both p < 0.001) and surgery (both p < 0.001) groups versus the RT group, with no differences between groups (OS, p = 0.45; CSS, p = 0.84). Patients who underwent elective node dissection (END) had better OS (p = 0.025) and CSS (p < 0.001) than those without END. No significant difference was observed in OS (p = 0.110) between the END and ST/RT groups; however, the END group showed significant improvement in CSS (p = 0.007). Patients who underwent bilateral neck dissection had better progression-free survival than the unilateral group after PSM (p = 0.024). CONCLUSION: Surgery combined with bilateral node dissection can bring better survival prognosis for patients with T3N0M0 glottic carcinoma.