The DAHANCA 27 Phase II Study: Transoral Laser Microsurgery for T1aN0M0 Glottic Squamous Cell Carcinoma, a Comparison to Accelerated Radiotherapy

Nina M Lyhne; Thomas Kjærgaard; Jesper F Tvedskov; Christian Godballe; Kirsten Hald; Benedicte P Ulhøi; Trine Printz; Jens Overgaard

doi:10.1002/hed.28225

The DAHANCA 27 Phase II Study: Transoral Laser Microsurgery for T1aN0M0 Glottic Squamous Cell Carcinoma, a Comparison to Accelerated Radiotherapy

Nina M Lyhne^*, Thomas Kjærgaard, Jesper F Tvedskov, Christian Godballe, Kirsten Hald, Benedicte P Ulhøi, Trine Printz, Jens Overgaard

^*Corresponding author for this work

Department of Otorhinolaryngology, Head and Neck Surgery and Audiology

1 Citation (Scopus)

Abstract

INTRODUCTION: Endoscopic surgery of T1a glottic squamous cell carcinoma (SCC) is believed to have advantages compared to radiotherapy (RT), including short duration, cost-effectiveness, repeatability, and RT reserved for second tumors/failures. The equality of tumor control probability after treatments is unresolved.

METHODS: In the DAHANCA 27 phase II study, selected Danish patients suspected of T1a glottic SCC between 2012 and 2016 were offered one-step diagnostic and curatively intended transoral laser microsurgery (TLM). The 5-year outcome was compared to a 2003-2012 national cohort of T1a glottic SCC patients treated with accelerated RT (accRT).

RESULTS: The TLM (n = 94) treatment included cordectomy type I (n = 44), II (n = 38), and III (n = 12). Failure was observed in 10/94 TLM and 36/534 accRT patients, resulting in 1 and 23 laryngectomies, respectively. The 5-year laryngectomy-free disease-specific survival was TLM 97.9% and accRT 94.6%, HR: 0.37 (0.09, 1.54).

CONCLUSIONS: Primary TLM for selected T1a glottic SCC patients is an organ preserving treatment with high disease control comparable to accRT.

Original language	English
Journal	Head and Neck
Volume	47
Issue number	12
Pages (from-to)	3228-3236
Number of pages	9
ISSN	1043-3074
DOIs	https://doi.org/10.1002/hed.28225
Publication status	Published - Dec 2025

Keywords

Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell/mortality
Denmark
Disease-Free Survival
Female
Glottis/pathology
Humans
Laryngeal Neoplasms/pathology
Laryngectomy/methods
Laser Therapy/methods
Male
Microsurgery/methods
Middle Aged
Natural Orifice Endoscopic Surgery/methods
Neoplasm Staging
Treatment Outcome
laser microsurgery
accelerated radiotherapy
national cohort
phase II study
early glottic cancer

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@article{dfc8c0b470e141c0a3fa326d40f283b4,

title = "The DAHANCA 27 Phase II Study: Transoral Laser Microsurgery for T1aN0M0 Glottic Squamous Cell Carcinoma, a Comparison to Accelerated Radiotherapy",

abstract = "INTRODUCTION: Endoscopic surgery of T1a glottic squamous cell carcinoma (SCC) is believed to have advantages compared to radiotherapy (RT), including short duration, cost-effectiveness, repeatability, and RT reserved for second tumors/failures. The equality of tumor control probability after treatments is unresolved.METHODS: In the DAHANCA 27 phase II study, selected Danish patients suspected of T1a glottic SCC between 2012 and 2016 were offered one-step diagnostic and curatively intended transoral laser microsurgery (TLM). The 5-year outcome was compared to a 2003-2012 national cohort of T1a glottic SCC patients treated with accelerated RT (accRT).RESULTS: The TLM (n = 94) treatment included cordectomy type I (n = 44), II (n = 38), and III (n = 12). Failure was observed in 10/94 TLM and 36/534 accRT patients, resulting in 1 and 23 laryngectomies, respectively. The 5-year laryngectomy-free disease-specific survival was TLM 97.9\% and accRT 94.6\%, HR: 0.37 (0.09, 1.54).CONCLUSIONS: Primary TLM for selected T1a glottic SCC patients is an organ preserving treatment with high disease control comparable to accRT.",

keywords = "Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell/mortality, Denmark, Disease-Free Survival, Female, Glottis/pathology, Humans, Laryngeal Neoplasms/pathology, Laryngectomy/methods, Laser Therapy/methods, Male, Microsurgery/methods, Middle Aged, Natural Orifice Endoscopic Surgery/methods, Neoplasm Staging, Treatment Outcome, laser microsurgery, accelerated radiotherapy, national cohort, phase II study, early glottic cancer",

author = "Lyhne, \{Nina M\} and Thomas Kj{\ae}rgaard and Tvedskov, \{Jesper F\} and Christian Godballe and Kirsten Hald and Ulh{\o}i, \{Benedicte P\} and Trine Printz and Jens Overgaard",

note = "{\textcopyright} 2025 The Author(s). Head \& Neck published by Wiley Periodicals LLC.",

year = "2025",

month = dec,

doi = "10.1002/hed.28225",

language = "English",

volume = "47",

pages = "3228--3236",

journal = "Head and Neck",

issn = "1043-3074",

publisher = "John Wiley \& Sons Inc.",

number = "12",

}

TY - JOUR

T1 - The DAHANCA 27 Phase II Study

T2 - Transoral Laser Microsurgery for T1aN0M0 Glottic Squamous Cell Carcinoma, a Comparison to Accelerated Radiotherapy

AU - Lyhne, Nina M

AU - Kjærgaard, Thomas

AU - Tvedskov, Jesper F

AU - Godballe, Christian

AU - Hald, Kirsten

AU - Ulhøi, Benedicte P

AU - Printz, Trine

AU - Overgaard, Jens

PY - 2025/12

Y1 - 2025/12

N2 - INTRODUCTION: Endoscopic surgery of T1a glottic squamous cell carcinoma (SCC) is believed to have advantages compared to radiotherapy (RT), including short duration, cost-effectiveness, repeatability, and RT reserved for second tumors/failures. The equality of tumor control probability after treatments is unresolved.METHODS: In the DAHANCA 27 phase II study, selected Danish patients suspected of T1a glottic SCC between 2012 and 2016 were offered one-step diagnostic and curatively intended transoral laser microsurgery (TLM). The 5-year outcome was compared to a 2003-2012 national cohort of T1a glottic SCC patients treated with accelerated RT (accRT).RESULTS: The TLM (n = 94) treatment included cordectomy type I (n = 44), II (n = 38), and III (n = 12). Failure was observed in 10/94 TLM and 36/534 accRT patients, resulting in 1 and 23 laryngectomies, respectively. The 5-year laryngectomy-free disease-specific survival was TLM 97.9% and accRT 94.6%, HR: 0.37 (0.09, 1.54).CONCLUSIONS: Primary TLM for selected T1a glottic SCC patients is an organ preserving treatment with high disease control comparable to accRT.

AB - INTRODUCTION: Endoscopic surgery of T1a glottic squamous cell carcinoma (SCC) is believed to have advantages compared to radiotherapy (RT), including short duration, cost-effectiveness, repeatability, and RT reserved for second tumors/failures. The equality of tumor control probability after treatments is unresolved.METHODS: In the DAHANCA 27 phase II study, selected Danish patients suspected of T1a glottic SCC between 2012 and 2016 were offered one-step diagnostic and curatively intended transoral laser microsurgery (TLM). The 5-year outcome was compared to a 2003-2012 national cohort of T1a glottic SCC patients treated with accelerated RT (accRT).RESULTS: The TLM (n = 94) treatment included cordectomy type I (n = 44), II (n = 38), and III (n = 12). Failure was observed in 10/94 TLM and 36/534 accRT patients, resulting in 1 and 23 laryngectomies, respectively. The 5-year laryngectomy-free disease-specific survival was TLM 97.9% and accRT 94.6%, HR: 0.37 (0.09, 1.54).CONCLUSIONS: Primary TLM for selected T1a glottic SCC patients is an organ preserving treatment with high disease control comparable to accRT.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Carcinoma, Squamous Cell/mortality

KW - Denmark

KW - Disease-Free Survival

KW - Female

KW - Glottis/pathology

KW - Humans

KW - Laryngeal Neoplasms/pathology

KW - Laryngectomy/methods

KW - Laser Therapy/methods

KW - Male

KW - Microsurgery/methods

KW - Middle Aged

KW - Natural Orifice Endoscopic Surgery/methods

KW - Neoplasm Staging

KW - Treatment Outcome

KW - laser microsurgery

KW - accelerated radiotherapy

KW - national cohort

KW - phase II study

KW - early glottic cancer

UR - https://www.scopus.com/pages/publications/105009859774

U2 - 10.1002/hed.28225

DO - 10.1002/hed.28225

M3 - Journal article

C2 - 40622110

SN - 1043-3074

VL - 47

SP - 3228

EP - 3236

JO - Head and Neck

JF - Head and Neck

IS - 12

ER -

The DAHANCA 27 Phase II Study: Transoral Laser Microsurgery for T1aN0M0 Glottic Squamous Cell Carcinoma, a Comparison to Accelerated Radiotherapy

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