Impact of Anterior Commissure Involvement on Local Control of Early Glottic Carcinoma Treated by Laser Microresection

Steiner, Wolfgang; Ambrosch, Petra; Rödel, R.; Kron, Martina

doi:10.1097/00005537-200408000-00031

Cited by 159 publications

(176 citation statements)

References 40 publications

(67 reference statements)

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“…Stage wise these were 1/14 T2, 2/12 T3, and 1/4 T4 tumors. In another study, it was seen that T1b or T2b tumors had increased local recurrence rates compared with T1a tumors [13]. In our study, we observed that one patient with T1b, one patient with T2, and two patients with T3 had recurrence.…”

Section: Discussionsupporting

confidence: 62%

“…In our study, we observed that one patient with T1b, one patient with T2, and two patients with T3 had recurrence. Although, the number of patients in our study was small, our findings together with those of earlier studies suggest that extensive lesions in the A-com may have an increased propensity for recurrence after laser microsurgery [12,13,19]. These patients may therefore require careful surveillance for early detection of recurrence after laser microsurgery.…”

Section: Discussionmentioning

confidence: 48%

“…Nevertheless recent reports with TOLS have found that the recurrence rate is higher for patients having A-com involvement than those without A-com involvement [12][13][14]. Furthermore, the resection of tumors with A-com involvement may result in post-operative scarring, synechiae, web or granuloma formation, and subsequent dysphonia.…”

Section: Introductionmentioning

confidence: 99%

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

Shenoy

Prashanth

Shivakumar

et al. 2012

Indian J Otolaryngol Head Neck Surg

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In the past few decades more and more number of tumors of the glottis and supraglottis are been treated with single stage transoral laser microsurgery (TOLS). TOLS for the treatment of glottic and supraglottic carcinoma with anterior commissure (A-com) and/paraglottic space involvement is associated with a high rate of recurrence. We prospectively evaluated the outcomes of laser microsurgery and the impact of second look operation in these patients. Twenty-three patients with glottic and supraglottic carcinoma underwent transoral laser micro resection of the lesions. Subsequently five patients underwent second look microlaryngeal evaluation 6-8 months later for non-satisfactory healing, poor voice, and or suspicion of recurrent disease. Patients with A-com involvement and or paraglottic space involvement were followed up longitudinally for the effectiveness and timing of second look microsurgery. After initial transoral laser micro resection, all patients achieved microscopically clear resection margins. At second look microlaryngeal evaluation, local recurrence was found in four of 23 patients. Of these, two patients were salvaged by second look surgery and are disease free, whereas in two others, the larynx had to be subjected to open surgical intervention. One of two had extensive local recurrent tumor and underwent total laryngectomy with neck dissection followed by postoperative radiotherapy. Tracheohyoidopexy was done with successful functional and oncologic outcome for another patient who had local recurrence for the third time. Only the patient who underwent total laryngectomy with neck dissection was subjected to adjuvant post-operative radiotherapy. Finally, larynx was saved in 21 out of 23 patients.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 48%

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

Shenoy

Prashanth

Shivakumar

et al. 2012

Indian J Otolaryngol Head Neck Surg

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“…Steiner et al 28 analyzed the influence of anterior commissure involvement on local recurrences, laryngeal preservation, and survival in 263 patients with early glottic cancer that underwent transoral laser microsurgery. It was shown that involvement of the anterior commissure affected the local control and organ preservation rates but not the survival rates.…”

Section: The Anterior Cmmissurementioning

confidence: 99%

Comparision of Transoral Laser and Open Partial Laryngectomy for T1 and T2 Glottic Cancer: A Review of literature.

Singh

2012

Int J of Biomed & Adv Res

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T1-T2 glottic carcinomas may be treated with conservative surgery or radiotherapy. The goals of treatment are cure and laryngeal voice preservation. The aim of the current study was to review the literature and discuss the optimal management of T1 and T2 glottic carcinoma. Literature review indicated that the local control, laryngeal preservation, and survival rates of patients were similar after transoral laser resection and open partial laryngectomy. Voice quality depended on the extent of resection for patients undergoing surgery; results for patients undergoing laser resection for limited lesions showed better Voice Handicap Index scores, whereas open partial laryngectomy yielded poorer results. The cost of treatment was more for open partial laryngectomy. Patients with well defined lesions suitable for transoral laser excision with a good functional outcome were treated with laser. Open partial laryngectomy was reserved for patients with locally recurrent tumors. This review has been conducted by analyzing the Data which has been displayed in Pubmed literature in the last 25 years on the topics of Transoral Laser and Open partial Laryngectomy in the management of T1 and T2 glottic cancer. The various original articles and review articles were analyzed and compared and a conclusion derived.

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“…Actualmente, hay reportes de la escuela alemana (Steiner) incluso del tratamiento satisfactorio de tumores en etapas avanzadas en carcinomas glóticos, supraglóticos, de cavidad oral e hipofaringe con resultados oncológicos comparables a las modalidades convencionales en un grupo seleccionado de pacientes. En estos estudios, se afirma que la selección de los pacientes es fundamental pues se debe obtener una buena visualización de la lesión tumoral vía transoral para plantear este tipo de tratamiento [7][8][9][10][11] . El uso del láser en carcinoma laríngeo fue descrito desde 1975 por Strong como el méto-do de elección de la exéresis de los T1.…”

Section: Patologías Con Indicaciones De Cirugía Láserunclassified

Láser en otorrinolaringología

Lanas

2006

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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RESUMENEsta revisión bibliográfica analiza los diferentes tipos de láser usados en otorrinolaringología, destacando las propiedades de cada uno. Posteriormente describe las características de una sesión con anestesia y uso de láser y las patologías con indicaciones de cirugía láser. Estas se clasifican en cinco rubros. Patología laringotraqueal, patología faringobucal, patología sinusal, otología y dermatología cérvico facial. En la primera se analizan: lesiones fonoquirúrgico, papilomatosis laríngea, parálisis laríngeas, laringomalacia, angioma subglótico, estenosis y displasia laríngea, cáncer laríngeo. En patología faríngea y bucal se analiza su uso en atresia coanal, amígdalas palatinas linguales, roncopatías, divertículo de Zenker. En fosas nasales se describen los usos en cirugía endoscópica (FEELS). En patología otológica se analiza su uso en CAE y oído medio, para concluir con las lesiones cervicofaciales.Palabras clave: Láser, patologías ORL. SUMMARYThis bibliographic review analyzes the different types of laser used in otorhinolaryngology, outlining the properties of each one. Later on it describes the characteristics of a session with anesthesia and use of laser and the and the pathologies with indications of laser surgery. These are classified in five items. Laryngotracheal pathology, pharyngobuccal pathology, sinusal pathology, cervicofacial otology and dermatology. In the first one, analysis is made of phonosurgical injuries, laryngeal papilomatosis, laryngeal paralysis, laryngomalacia, subglotic angioma, stenosis and laryngeal dysplasia, laryngeal cancer. In pharyngeal and buccal pathology, its use is analized in choanal atresia, lingual palatine tonsils, hoarseness, Zenker's diverticulum. In nasal fossae the uses on endoscopic surgery are described (FEELS). In otologic pathology its use is analyzed on CAE and middle ear, to end with cervicofacial injuries.

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Impact of Anterior Commissure Involvement on Local Control of Early Glottic Carcinoma Treated by Laser Microresection

Abstract: This study shows the effectiveness of laser microsurgery for early glottic carcinoma regardless of anterior commissure involvement at presentation. This method can be performed as an outpatient procedure, even when conducting reresections.

Cited by 159 publications

References 40 publications

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

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

Comparision of Transoral Laser and Open Partial Laryngectomy for T1 and T2 Glottic Cancer: A Review of literature.

Láser en otorrinolaringología

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