Transoral laser microsurgery as primary treatment for selected T3 glottic and supraglottic cancers

Head Neck. 2016 Jul;38(7):1107-12. doi: 10.1002/hed.24424. Epub 2016 Mar 11.

Abstract

Background: T3 laryngeal cancer encompasses heterogeneous lesions whose treatment is still debated. The purpose of this study was to evaluate transoral laser microsurgery (TLM) in management of selected T3 glottic and supraglottic cancers.

Methods: Fifty-six patients with selected T3 glottic and supraglottic squamous cell carcinomas (SCCs) treated by TLM ± selective neck dissection ± adjuvant therapy were evaluated in terms of overall survival (OS), disease-free survival (DFS), and organ preservation rates.

Results: For the entire cohort, 5-year OS and DFS were 63.3% and 72.4%, whereas they were 65.2% and 72.9% for glottic and 59.3% and 76.3% for supraglottic SCC, respectively. No patient required permanent tracheostomy and 1 patient was gastrostomy tube-dependent at last follow-up.

Conclusion: TLM ± selective neck dissection ± adjuvant (chemo)radiotherapy for selected T3 glottic and supraglottic SCC represents an effective alternative treatment to open partial laryngectomies and nonsurgical organ preservation protocols, particularly in elderly and frail patients. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1107-1112, 2016.

Keywords: T3 category; glottic cancer; oncologic outcomes; supraglottic cancer; transoral laser microsurgery.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery*
  • Carcinoma, Squamous Cell / therapy
  • Chemoradiotherapy, Adjuvant
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Glottis / pathology
  • Glottis / surgery
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / surgery*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology*
  • Laryngeal Neoplasms / surgery*
  • Laryngeal Neoplasms / therapy
  • Laser Therapy / methods*
  • Male
  • Microsurgery / methods*
  • Middle Aged
  • Natural Orifice Endoscopic Surgery / methods
  • Neoplasm Grading
  • Organ Sparing Treatments / methods
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Analysis
  • Treatment Outcome