Background: Early-stage laryngeal squamous cell carcinoma (T1-T2) can be treated with either radiation therapy or surgery, but the cost-effectiveness of these treatments is unclear.


Methods: This study is a cost-effectiveness analysis comparing radiation therapy and surgery as treatments for early-stage laryngeal squamous cell carcinoma (T1-T2) at a university hospital's tertiary care center. A consecutive sampling method was used to select 86 patients (43 per group) diagnosed with early-stage laryngeal squamous cell carcinoma (T1-T2) between January 2018 and December 2020. Demographic, clinical, and cost data were collected, and quality of life data were collected using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).


Results: The mean total cost for patients treated with radiation therapy was ¥123,419, which was significantly lower than the mean total cost for patients treated with surgery (¥153,219, p=0.012). The mean QALYs for patients treated with radiation therapy was 4.21 (± 1.23), which was slightly higher than the mean QALYs for patients treated with surgery (3.92 ± 1.35), but the difference was not statistically significant (p=0.142). The incremental cost-effectiveness ratio (ICER) was ¥24,011 per QALY gained, indicating that radiation therapy was associated with a lower cost per QALY gained compared to surgery. At a willingness-to-pay (WTP) threshold of ¥50,000 per QALY, the probability that radiation therapy is cost-effective is 72.1%.


Conclusion: Radiation therapy is a cost-effective treatment option for early-stage laryngeal squamous cell carcinoma (T1-T2) compared to surgery, with a lower ICER and a higher probability of cost-effectiveness at various WTP thresholds. These findings can inform treatment decisions and resource allocation in the management of early-stage laryngeal squamous cell carcinoma.