(0830) Primary T3 Laryngeal Squamous Cell Carcinoma: Real-World Data From a Large NHS Cancer Centre, 2016–2022

Introduction: Larynx squamous cell carcinoma (SCC) represents 30-40% of head and neck cancer cases. T3 larynx cancer is often treated with organ-preserving protocols, including non-surgical modalities, with treatment decision-making closely dependent on patient-related factors. Understanding the real-world outcomes of such approaches is beneficial. We aimed to characterise the T3 cohort at Guy’s and St Thomas’ NHS Foundation Trust (UK) and describe oncological outcomes after curative first-line treatment, with specific focus on primary radiotherapy (RT) vs chemoradiotherapy (CRT).

Methods: Data on patients diagnosed with primary larynx SCC between January 1, 2016–December 31, 2022 was extracted from electronic health records. Descriptive statistics and cox proportional hazard regression were used.

Results: Of N = 267 patients with primary larynx SCC, N = 91 (34%) presented with T3 tumors. Most were male (N = 73, 80%), of White ethnicity (N = 65, 74%), current/ex-smokers (N = 88, 97%) and in the lowest two quintiles for socioeconomic status (N = 50, 55%). This appeared representative of the wider larynx SCC cohort. Most T3 patients were treated curatively (N = 67, 74%), of which N = 43 (64%) with CRT, N = 17 (25%) with RT, and N = 7 (10%) with surgery. Median overall survival (OS) for the T3 cohort was 43 months, with 1-year and 5-year OS of 87% and 41%, respectively. After adjusting for age, nodal status, and performance status the hazard ratio (HR) for RT vs CRT was 4.64 (95% CI 1.24-17.37).

Conclusions: In this real-world setting, most T3 patients were treated with primary oncological modalities rather than surgery. Patients undergoing RT appeared to have poorer survival outcomes than CRT, although we acknowledge the limitations of a small sample size. Further investigations into mediators and selection mechanisms are required.