Outcomes of transoral laser microsurgical management of T1b stage glottic cancer

J Laryngol Otol. 2017 May;131(5):433-441. doi: 10.1017/S0022215117000329. Epub 2017 Feb 14.

Abstract

Objective: This study aimed to evaluate the oncological and voice outcomes of transoral laser microsurgery for tumour stage T1b stage glottic cancer patients.

Methods: A prospective cohort study in a tertiary care head and neck cancer centre included tumour-node-metastasis stage T1bN0M0 glottic cancer patients scheduled to undergo transoral laser microsurgery from January 2002 until June 2014. Kaplan-Meier five-year analyses of local control, overall survival, disease-specific survival and laryngeal preservation were performed. Voice Handicap Index-10 scores and maximum phonation times were also recorded.

Results: Twenty-one participants with a mean age of 66.8 years were enrolled. The mean follow up was 56.5 months. Kaplan-Meier 5-year survival analysis illustrated a local control rate of 82 per cent, overall survival of 88 per cent, disease-specific survival of 100 per cent, and laryngeal preservation of 100 per cent. The pre-operative Voice Handicap Index-10 score was 19.1 ± 9.47 (mean ± standard deviation (SD)) and the post-operative scores were 13.5 ± 9.29 at three months, 10.44 ± 9.70 at one year and 5.83 ± 4.91 at two years. The pre-operative maximum phonation time was 16.23 ± 5.46 seconds (mean ± SD) and the post-operative values were 14.44 ± 6.73 seconds at three months, 15.27 ± 5.71 seconds at one year and 14.33 ± 6.44 seconds at two years.

Conclusion: Transoral laser microsurgery yields relatively high rates of oncological control and acceptable voice outcomes, and thus shows utility as a primary treatment modality for T1b glottic cancer.

Keywords: Squamous Cell; Carcinoma; Laryngeal Neoplasms; Laser Therapy; Treatment Outcome.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Disease-Free Survival
  • Glottis / pathology
  • Glottis / surgery
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laser Therapy / methods*
  • Male
  • Microsurgery / methods*
  • Middle Aged
  • Natural Orifice Endoscopic Surgery / methods*
  • Neoplasm Staging
  • Prospective Studies
  • Treatment Outcome
  • Voice Quality