CO2 laser surgery for verrucous carcinoma of the larynx

Damm, Michael; Eckel, Hans Edmund; Schneider, D.; Arnold, Georg J.

doi:10.1002/(sici)1096-9101(1997)21:2<117::aid-lsm2>3.0.co;2-t

Cited by 24 publications

(23 citation statements)

References 20 publications

(36 reference statements)

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“…The benefits of carbon laser surgery have been related to the precise application, minimal bleedings and tissue damage of surgical trauma, and rapid healing. 11,14,15 It has been reported to cause minimal morbidity, have good functional results, and provide a cost‐effective alternative to open surgical procedures and to radiotherapy. 13 Only four patients treated in this fashion had local recurrence, only one patient required more than one additional endoscopic intervention, and only two patients in our series had temporary postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, encouraging results have been reported for the minimally invasive surgical approach using microlaryngoscopic removal of the diseased mucosa with the help of surgical lasers. 11–15 However, only insufficient data on long‐term results of transoral laser surgery have been reported in the literature, particularly on ultimate rates of laryngeal preservation. 10 …”

Section: Introductionmentioning

confidence: 99%

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Transoral CO₂ Laser for Surgical Management of Glottic Carcinoma in Situ

et al. 2000

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Objectives/Hypothesis: In carcinoma in situ (CIS) tumors malignant cells have not penetrated the basement membrane and therefore have no metastatic potential. Treatment strategies of CIS are topics of ongoing discussion. The aim of this study was to evaluate long-term results of C0 2 laser therapy in laryngeal CIS. Methods: From 1986 to 1995, 29 patients with glottic CIS with a minimum follow-up of 2 years were treated initially with transoral C0 2 laser surgery and were included is this series. Results: A complete removal of the tumor was possible with superficial laser cordectomy in 21 patients and with subligamental laser cordectomy in 8 cases. There was no tumorrelated death in this series. Repeated laser resections were performed in four patients for local recurrences. No patient required total laryngectomy or radiotherapy during a follow-up ranging from 25 to 143 months. Conclusions: Local control rates presented in this study are superior to those previously reported with conventional surgery and similar to those after radiotherapy. The ultimate rate oflarynx preservation was seven times higher than reported after radiotherapy. Our results add further support to the observation that laser surgery is the best treatment option for CIS of the larynx. Based on the material of this study, recommended treatment for CIS is C0 2 laser resection in combination with a meticulous follow-up for early recognition of local recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transoral CO₂ Laser for Surgical Management of Glottic Carcinoma in Situ

et al. 2000

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“…The surgical technique for the transoral approach to early-stage larynx carcinoma used throughout this study has previously been described in detail [4,6,7,36,38]. In brief, a CO 2 surgical laser was coupled to a Zeiss operating microscope and was generally set at an output power of 2-6 W in a super-pulse mode at a spot size of approximately 0.8 mm 2 .…”

Section: Surgical Techniquementioning

confidence: 99%

“…Besides these well-established oncological approaches, transoral laser surgery has emerged as a major therapeutic alternative [3,4,8,24,27,34,35]. Although endoscopic laser surgery for the treatment of laryngeal neoplasms was first described and used in the United States, it has found wider acceptance in clinical practice in Europe.…”

Section: Introductionmentioning

confidence: 99%

Transoral laser surgery for early glottic carcinoma

Eckel¹,

Thumfart

Jungehülsing³

et al. 2000

European Archives of Oto-Rhino-Laryngology

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This prospective study evaluates the oncological results of transoral laser surgery (TLS) for glottic carcinoma categorized Tis, T1 and T2 in a large, unselected group of 285 consecutive patients from a university-based referral center that uses transoral laser surgery as the standard approach to these tumors. Patients were treated between 1 January 1987 and 31 December 1996. Thirty-three patients had Tis disease, 174 T1 tumors and 113 T2. Main outcome measures were local control with initial therapy, ultimate local control, regional control, organ preservation, overall survival and cause-specific survival. The 5-year uncorrected actuarial survival for all 285 patients was 71.1%, and cause-specific actuarial survival was 98.7%. Local control with initial treatment was 85.9%, ultimate local control with salvage for local treatment failures 98.5%, and regional control 98.4%. In all, 94.3% had their larynges preserved after 5 years. Although favorable oncological results for early laryngeal carcinoma treated with laser surgery are supported this study, no definitive recommendations can be given for the best single treatment. Partial laryngectomies lead to the highest local control rates reported so far, radiotherapy is believed to preserve voice best and laser surgery is associated with time- and cost-effectiveness, low morbidity, fair local control rates and excellent re-treatment options in case of local failure. All specialists dealing with the treatment of early glottic carcinoma should be able to offer these different treatment modalities to their patients and to deal specifically with each patient's individual needs and preferences.

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“…Zur Therapie werden strahlentherapeutische oder chirurgische Behandlungskonzepte eingesetzt [4,9]. Ergebnisse der Kohlenstoff-Dioxid-(CO 2 )-Laserchirurgie fehlen fast vollständig in der Literatur [10,11]. Uneinigkeit besteht jedoch insbesondere über die zur Therapie erforderliche Radikalität.…”

Section: Introductionunclassified