Retrospective analysis of factors influencing oncologic outcome in 590 patients with early-intermediate glottic cancer treated by transoral laser microsurgery

Head Neck. 2017 Jan;39(1):71-81. doi: 10.1002/hed.24534. Epub 2016 Jul 25.

Abstract

Background: The purpose of this study was to identify the factors influencing oncologic outcomes for patients with early-intermediate glottic cancer treated by transoral laser microsurgery (TLM).

Methods: This was a retrospective mono-institutional study. A total of 590 patients with cTis-cT3 glottic cancer underwent TLM with curative intent.

Results: TLM alone was performed in 538 patients (91.2%) and TLM followed by adjuvant radiotherapy (RT) was done in 52 (8.8%). Five-year recurrence-free survival (RFS) and 10-year overall survival (OS) were 85.3% and 74.7%, respectively. The larynx-preservation ratio was 95.9%. In particular, from our data, we found that occult metastases were rare (1.2%); preventive tracheotomy was not necessary; the local recurrence rate of Tis was similar to that in the T2 and T3 group; and no major or lethal complications were observed.

Conclusion: Age (>60 vs ≤60), type of cordectomy (≥IV vs ≤III), status of margins, fixed arytenoid, and pathologic T classification, were the variables associated with RFS, OS, and organ-preservation rate. © 2016 Wiley Periodicals, Head Neck 39: 71-81, 2017.

Keywords: laryngeal cancer; organ preservation; overall survival; relapse-free survival; transoral laryngeal microsurgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Carcinoma / surgery*
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Glottis*
  • Humans
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laser Therapy*
  • Male
  • Microsurgery*
  • Middle Aged
  • Neoplasm Staging
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome