Patterns of Care for T1 Glottic Squamous Cell Carcinomas from 2004–2020.

Objective(s): Describe recent national trends in overall treatment modalities for T1 glottic squamous cell carcinomas (SCC), and identify factors associated with treatment regimens. Methods: National Cancer Database from 2004–2020 was queried for all patients with glottic cT1N0M0 SCC. Treatment patterns over time were analyzed using the Cochran‐Armitage test for trend. Multivariable logistic regressions were used to determine the factors associated with treatment regimens. Results: Of the 22,414 patients identified, most patients received RT only (57%), 21% received surgery only, and 22% received dual‐modality treatment ("over‐treatment"). Over the time period, there was a decreasing trend in rates of over‐treatment for T1 glottic SCC (p < 0.001) and an increasing trend in surgery only (p < 0.001). Treatment in 2016–2018 (OR: 1.168 [1.004 to 1.359]), 2013–2015 (OR: 1.419 [1.221 to 1.648]), 2010–2012 (OR: 1.611 [1.388 to 1.871]), 2007–2009 (OR: 1.682 [1.450 to 1.951]), or 2004–2006 (OR: 1.795 [1.548 to 2.081]) versus 2019–2020 was associated with greater likelihood of over‐treatment. T1b tumors were less likely to be over‐treated (OR: 0.795 [0.707 to 0.894]) versus T1a tumors, and less likely to receive surgery first (OR: 0.536 [0.485 to 0.592]) versus T1a tumors. Conclusion: Over‐treatment for T1 glottic SCC has been declining, with increasing rates of surgery only. Year of treatment was significantly associated with the receipt of dual‐modality treatment. Finally, patients with T1b disease were more likely to receive RT as the first and only treatment. Level of Evidence: 3 Laryngoscope, 134:3633–3644, 2024 [ABSTRACT FROM AUTHOR]