Transoral laser microsurgery in treatment of pT2 and pT3 glottic laryngeal squamous cell carcinoma - results of 391 patients

Head Neck. 2014 Jun;36(6):859-66. doi: 10.1002/hed.23389. Epub 2013 Sep 2.

Abstract

Background: The purpose of this study was to evaluate oncological and functional results of transoral laser microsurgery (TLM) in patients with T2 and T3 glottic laryngeal squamous cell carcinoma (SCC).

Methods: A retrospective chart analysis was carried out. Cases were classified into categories pT2a, pT2b, and pT3. Treatment was exclusively TLM ± selective neck dissection and adjuvant (chemo)radiotherapy.

Results: Three hundred ninety-one patients were treated by TLM; 142 cases were category pT2a, 127 were pT2b, and 122 were pT3. Median follow-up was 71 months. Five-year overall, recurrence-free, and disease specific survival rates were 72.2%, 76.4%, and 93.2% for pT2a tumors, 64.9%, 57.3%, and 83.9% for pT2b tumors, and 58.6%, 57.8%, and 84.1% for pT3 tumors, respectively. Larynx preservation was achieved in 93% (pT2a) and 83% (pT2b and pT3).

Conclusion: Results are comparable to open partial or total laryngectomy and superior to primary (chemo)radiotherapy. TLM results in a lower morbidity and superior function compared to standard treatment.

Keywords: T2-3 glottic laryngeal carcinoma; larynx; oncologic and functional outcomes; organ preservation; transoral laser microsurgery.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Carcinoma, Squamous Cell / therapy
  • Chemoradiotherapy, Adjuvant / methods
  • Female
  • Follow-Up Studies
  • Glottis / physiopathology
  • Glottis / surgery
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laryngeal Neoplasms / therapy
  • Laryngectomy* / methods
  • Laser Therapy* / methods
  • Male
  • Medical Records Systems, Computerized
  • Microsurgery / methods
  • Middle Aged
  • Natural Orifice Endoscopic Surgery* / methods
  • Neck Dissection
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / surgery*
  • Neoplasm Recurrence, Local / therapy
  • Neoplasm Staging
  • Organ Sparing Treatments / methods*
  • Recovery of Function
  • Retrospective Studies
  • Salvage Therapy / methods
  • Treatment Outcome