In Reply We thank Drs D’Ascanio and Piazza for their comments regarding our study demonstrating similar overall survival outcomes for patients with T3N0M0 glottic carcinoma treated with surgery or radiotherapy.1 We fully agree that individual patients in the T3 category may exhibit distinct pathophysiologies, be more appropriately treated by particular therapy approaches, and demonstrate dissimilar clinical outcomes.2,3 Such staging granularity, however, does not exist in the National Cancer Database. The primary intent of our study was to evaluate whether overall survival for all T3N0M0-staged patients treated with primary radiotherapy-based approaches revealed a decrement in survival, as has been suggested by several smaller studies in contrast to the randomized clinical trial data supporting equipoise between these approaches.4,5 Equivalence in overall survival between surgery and radiation was supported by our analysis.
Witek ME, Hartig GK, Harari PM. Survival Outcomes for Patients With T3N0M0 Squamous Cell Carcinoma of the Glottic Larynx—Reply. JAMA Otolaryngol Head Neck Surg. Published online April 05, 2018. doi:10.1001/jamaoto.2018.0083
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