Functional and Oncologic Outcomes of Octogenarians Undergoing Transoral Laser Microsurgery for Laryngeal Cancer

Changseok Lee; David Forner; Christopher W Noel; Victoria Taylor; Colin MacKay; Matthew H Rigby; Martin Corsten; Jonathan R Trites; S Mark Taylor

doi:10.1177/2473974X211046957

Functional and Oncologic Outcomes of Octogenarians Undergoing Transoral Laser Microsurgery for Laryngeal Cancer

OTO Open. 2021 Sep 29;5(3):2473974X211046957. doi: 10.1177/2473974X211046957. eCollection 2021 Jul-Sep.

Authors

Changseok Lee¹, David Forner¹, Christopher W Noel², Victoria Taylor¹, Colin MacKay¹, Matthew H Rigby¹, Martin Corsten¹, Jonathan R Trites¹, S Mark Taylor¹

Affiliations

¹ Division of Otolaryngology-Head and Neck Surgery, Queen Elizabeth II Health Sciences Center and Dalhousie University, Halifax, Canada.
² Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada.

Abstract

Objective: To evaluate the oncologic and functional outcomes of transoral laser microsurgery (TLM) for glottic cancers in patients ≥80 years.

Study design: Prospectively collected case series.

Setting: QEII Health Sciences Centre, Halifax, Canada.

Methods: This case series used a prospectively collected glottic cancer database to examine consecutive elderly patients (≥80 years old) undergoing TLM. Kaplan-Meier analysis was used to evaluate rates of disease-free, disease-specific, and overall survival as the primary end points of oncologic control. Secondary functional outcomes included voice function, length of hospital stay, and time to readmission.

Results: From 2005 to 2017, 17 octogenarian patients underwent TLM for glottic cancer. Median follow-up was 4.19 years (interquartile range, 0.71-6.95). Kaplan-Meier estimates of 5-year survival were 78.4% (disease free), 92.9% (disease specific), and 81.9% (overall). The median length of hospital stay was 1 day (range, 0-8). There was only 1 readmission within 30 days of surgery. No patients in this study developed significant surgical or postoperative complications requiring unplanned readmissions. Patient-perceived voice function improved to normal after treatment in 62.5% of patients.

Conclusion: The results of this study suggest that TLM is a safe and effective treatment modality for glottic cancer in patients aged ≥80 years, providing good oncologic control and satisfactory functional outcomes.

Keywords: complications; frailty; geriatrics; glottic cancer; head and neck neoplasms; larynx cancer; transoral laser microsurgery; voice function.