Transoral laser microsurgery or total laryngectomy for recurrent squamous cell carcinoma of the larynx: Retrospective analysis of 199 cases

Head Neck. 2017 Jun;39(6):1166-1176. doi: 10.1002/hed.24737. Epub 2017 Mar 2.

Abstract

Background: Surgical treatment options for local recurrences of laryngeal cancer can be either organ-preserving surgery or total laryngectomy. The purpose of this study was to present our evaluation of the treatment with transoral laser microsurgery (TLM) in comparison to laryngectomy.

Methods: We conducted a retrospective review of 199 consecutive patients with recurrent laryngeal cancer at 1 tertiary referral center.

Results: The 5-year overall survival, disease-specific survival, and local control rates were 64.8%, 79.6%, and 57.5%, respectively, for 93 patients with early tumors treated by TLM, 28.9%, 41.7%, and 43.7%, respectively, for 52 patients with advanced tumors treated by TLM as well as 39.4%, 44.6%, and 68.8%, respectively, for 54 patients with advanced tumors treated by total laryngectomy. Five-year larynx-preservation rate was 77.7% for early as well as 68.4% for advanced tumors treated by TLM.

Conclusion: TLM is an option in early and in selected cases of advanced locally recurrent laryngeal cancer. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1166-1176, 2017.

Keywords: laryngeal neoplasms; laryngectomy; local; neoplasm recurrence; retrospective study; 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
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / surgery
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery
  • Laryngectomy / methods*
  • Laryngectomy / mortality
  • Laser Therapy / methods*
  • Laser Therapy / mortality
  • Male
  • Microsurgery / methods*
  • Microsurgery / mortality
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery*
  • Neoplasm Staging
  • Retrospective Studies
  • Risk Assessment
  • Salvage Therapy / methods
  • Squamous Cell Carcinoma of Head and Neck
  • Statistics, Nonparametric
  • Survival Analysis