ArticleCureus2026
Clinical and Treatment-Related Factors Associated With Recurrence After Definitive Radiotherapy for Early-Stage Glottic Squamous Cell Carcinoma: A Retrospective Cohort Study in Panama.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDefinitive radiotherapy is a standard larynx-preserving treatment for early-stage glottic squamous cell carcinoma. This study evaluated recurrence patterns and freedom from recurrence after definitive radiotherapy in Panama; explored baseline clinical, pathological, and treatment-related factors associated with recurrence; and analyzed initial post-treatment response as an early marker of subsequent recurrence risk.
methodsWe conducted a retrospective cohort study of adults diagnosed between 2013 and 2022 with T1-T2 N0 M0 glottic squamous cell carcinoma and treated with definitive radiotherapy at the National Oncology Institute of Panama. Time to recurrence, event-free survival, overall survival, and laryngeal preservation with oncologic control were evaluated. Freedom from recurrence was estimated using the Kaplan-Meier method, with deaths without prior recurrence censored. Survival outcomes were compared using log-rank tests and Cox proportional hazards models.
resultsNinety-four patients were included: 79.8% had T1a, 13.8% had T1b, and 6.4% had T2 disease; 94.7% received three-dimensional conformal radiotherapy. An initial complete response was achieved in 86/93 patients (92.5%). With a median observed follow-up of 65.9 months (38.6-96.6), 17/94 patients (18.1%) developed recurrence: local recurrence occurred in 13.8% and regional recurrence in 4.3%, with no distant metastases. Freedom from recurrence at two and five years was 87.0% and 80.2%, respectively; five-year event-free survival was 70.4%, and five-year overall survival was 81.7%. Laryngeal preservation with oncologic control was achieved in 77/94 patients (81.9%). Partial response was associated with lower five-year freedom from recurrence compared with complete response (28.6% vs. 84.2%; p < 0.001). Five-year freedom from recurrence was 85.4% with hypofractionation and 78.5% with conventional fractionation (p = 0.483).
conclusionIn this retrospective cohort with a median observed follow-up of 65.9 months, definitive radiotherapy achieved a high initial complete response rate, predominantly local recurrence patterns, and a five-year freedom from recurrence of 80.2%, with deaths without prior recurrence censored. Partial response identified a high-risk subgroup as an early post-treatment response marker. Hypofractionation showed a non-significant numerical trend toward higher five-year freedom from recurrence, but the study did not demonstrate superiority, equivalence, or non-inferiority between fractionation schedules.
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