Endoscopic CO₂ Laser Excision for Tis, T1, and T2 Glottic Carcinomas: Cure Rate and Prognostic Factors

Abstract

We present the results of a retrospective study based on a cohort of 140 patients who underwent endoscopic CO(2) laser excision for previously untreated early glottic cancer (21 Tis, 96 T1, and 23 T2). This study used univariate analysis to review the impact on disease-free survival of 15 factors related to the host, the tumor, and the treatment. Recurrent cancer developed in 28 patients with an average interval to recurrence of 37.5 months. Retreatment consisted of different procedures, including laser excision, partial or total laryngectomy, and/or radiotherapy. The larynx was definitively preserved in 96% of patients. By the end of the study, 14 patients had died, but only 2 of them had died of the disease. Five-year overall survival and determinate survival were 93% and 98%, respectively. Ultimate local control at 5 years with CO(2) laser excision alone was 95% for Tis, 87% for T1, and 91% for T2 lesions. Only involvement of the anterior third of the vocal cord (P = 0.02), involvement of the false vocal cord (P = 0.02), and infiltration of the vocalis muscle (P = 0.004) showed a significant negative impact on disease-free survival.

The Utility of Second Look Microlaryngoscopy after Trans Oral Laser Resection of Laryngeal Cancer

“…Peretti et al [18], in their study noted that infiltration of the vocalis muscle is one of the significant prognostic factors for disease free survival. Infiltration of the vocalis muscle necessitates more extensive laser resections to obtain a good margin.…”

Long-Term Functional Outcome after Unilateral Cordectomy

“…Endoscopic laser cordectomy has proven to be effective in terms of local control, survival and vocal function for early glottic carcinoma [1,2] . Compared to radiotherapy laser cordectomy was found to be equal [3,4] or superior [5,6] .…”

Avaliação da voz em pacientes submetidos à cordectomia com laser de CO2

“…Cure rates for CO 2 laser treated patients with early glottic tumors vary from 89% to 100% 4,14,[16][17][18] and are similar to radiotherapy cure rates 19,20 .…”

“…Since Strong & Jako introduced CO 2 laser in laryngeal surgery in 1972 7 , this therapeutic strategy has gained worldwide acceptance for the treatment of laryngeal tumors, particularly for early glottic tumors 3,4,[8][9][10][11][12][13][14][15] .…”