In this study, we sought to determine current trends in the management of glottic cancer in Canada. We further sought to determine the approach to margin status following treatment of glottic cancer.
An online survey was distributed to all head and neck (H&N) surgeons and all radiation oncologists (ROs) in Canada. Respondents were asked to choose management recommendations for a series of tumour descriptions and to offer their opinion of margin evaluation. The results were compiled and analyzed using descriptive statistics for frequencies and chi-square analysis for comparison between H&N surgeons and ROs.
The survey attained a response rate of 60% among H&N surgeons and 20% among ROs. There was a significant difference in choice of management for T1a, T1b, T2a, and T2b tumours, with ROs heavily favouring radiation therapy and H&N surgeons' opinions divided between radiation therapy and transoral laser microsurgery (TLM). There was no significant difference of opinion in the treatment of T3 and T4a tumours. The size of an adequate margin was significantly different between ROs and H&N surgeons, as was the management of a positive margin.
Compared to previous surveys, this study reflects a move toward TLM as the preferred treatment for T1a glottic cancer among H&N surgeons, whereas ROs continue to favour radiation therapy. The results also show a split in opinions among H&N surgeons with respect to TLM versus radiation therapy for early-stage glottic tumours. The study underscores a difference of opinion between specialties regarding the management of glottic cancer and the need for a definitive comparison study to guide recommendations.