Transoral laser microsurgery for early glottic cancer as one-stage single-modality therapy

Laryngoscope. 2013 Nov;123(11):2670-4. doi: 10.1002/lary.24080. Epub 2013 Apr 1.

Abstract

Objectives/hypothesis: A study was undertaken to determine the oncologic outcomes in a consecutive series of early glottic carcinomas treated with transoral CO₂ laser microsurgery (TLM) as a one-stage single-modality therapy, without any postoperative radiation therapy or retreatment with laser. We further evaluated correlations between the oncologic outcomes and clinicopathologic factors including tumor location and surgical margin.

Study design: Retrospective analysis of medical records.

Methods: The medical records of 118 consecutive patients with early stage (T1, T2) glottic carcinoma who underwent TLM by a single surgeon as an initial treatment from 1997 to 2011 were retrospectively reviewed. The oncologic outcomes were evaluated, and correlations to clinicopathologic factors were analyzed.

Results: The 5-year disease-free survival, ultimate local control with laser alone, disease-specific survival, overall survival, and organ preservation rates were 87.9%, 94.2%, 99.0%, 92.2%, and 96.2%, respectively. Neither the reported surgical margin nor the extension of tumor to the anterior commissure, arytenoid, subglottis, and ventricle showed any significant impact on local control or survival.

Conclusions: Transoral CO₂ laser microsurgery as one-stage single-modality therapy resulted in a high rate of local control and a high survival rate in selected cases of early glottic carcinoma, regardless of the location of tumor and histopathology report on the surgical margin.

Keywords: Laryngeal carcinoma; carbon dioxide laser; glottis; laryngoscopic surgery; squamous cell carcinoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Glottis / surgery*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laser Therapy / methods*
  • Lasers, Gas / therapeutic use*
  • Male
  • Microsurgery / methods*
  • Middle Aged
  • Mouth
  • Neoplasm Staging
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck