Transoral plasma radiofrequency ablation for selected supraglottic and glottic laryngeal cancer: a propensity score-matched comparative study.

INTRODUCTION: Transoral endoscopic surgery is a preferred treatment for early-stage and selected advanced laryngeal cancers. Transoral plasma radiofrequency ablation (TPRA) has shown promise for glottic cancer, however, its efficacy in T1-T2 supraglottic and selected advanced T2-T3 glottic cancers requires further evaluation. METHODS: We retrospectively compared 31 patients with T1-T2 supraglottic or T2-T3 glottic cancers treated with TPRA with 36 patients treated with open partial laryngeal surgery. Disease-specific survival (DSS), disease-free survival (DFS), and local control (LC) were analyzed using multivariable Cox proportional hazards regression. Postoperative outcomes and preservation of laryngeal function were also evaluated. RESULTS: After propensity score matching, 67 patients were included in the analysis. The TPRA group had a shorter median hospital stay (8 days), and no patient required synchronous tracheotomy or experienced postoperative bleeding. Functional recovery was generally faster than in the open surgery group, including avoidance of routine nasogastric tube feeding. Temporary dysphagic cough (25.8%) and granulation tissue (16.1%) were observed. The 5-year DSS, DFS, and LC rates after TPRA were 77.4%, 71.0%, and 83.1%, respectively, which were comparable to those after open surgery (74.8%, 72.2%, and 84.9%, respectively; all P > 0.05). CONCLUSION: TPRA demonstrated oncologic efficacy comparable to open surgery for selected T1-T2 supraglottic and T2-T3 glottic cancers, with better functional preservation and fewer perioperative complications. Together with its technical adaptability, TPRA may represent a valuable treatment option for carefully selected patients.