Laryngeal recurrence sites in patients previously treated with transoral laser microsurgery for squamous cell carcinoma

Horwich, Peter; Rigby, Matthew H.; Mackay, Colin; Melong, Jonathan C.; Williams, Blair; Bullock, Martin; Hart, Robert D.; Trites, Jonathan; Taylor, S. Mark

doi:10.1186/s40463-018-0266-y

Cited by 10 publications

(7 citation statements)

References 13 publications

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“…22 In this view, CO 2 TOLMS should be regarded as a repeatable procedure, and patients should be carefully monitored according to dedicated protocols, including seriate biologic endoscopic and radiologic examinations, [23][24][25] to avoid late diagnosis of recurrence/metachronous tumor in the presence of laryngeal framework involvement. 26 Our data confirm that CO 2 TOLMS, with adequate indications and patient selection, provides optimal oncologic results as a salvage procedure after previous transoral laser surgery, as already demonstrated by our group in the clinical setting of failure after RT. 27,28 In recurrent cases not manageable by CO 2 TOLMS, it should be considered that OPHL, although associated with lower OP, resulted in a better DSS than RT.…”

Section: Discussionsupporting

confidence: 87%

“…These results confirm the importance of treating EIGSCC with a single‐treatment modality, 21 avoiding RT in case of persistence, recurrence, or second tumor still amenable to CO 2 TOLMS 22 . In this view, CO 2 TOLMS should be regarded as a repeatable procedure, and patients should be carefully monitored according to dedicated protocols, including seriate biologic endoscopic and radiologic examinations, 23–25 to avoid late diagnosis of recurrence/metachronous tumor in the presence of laryngeal framework involvement 26 . Our data confirm that CO 2 TOLMS, with adequate indications and patient selection, provides optimal oncologic results as a salvage procedure after previous transoral laser surgery, as already demonstrated by our group in the clinical setting of failure after RT 27 , 28 .…”

Section: Discussionsupporting

confidence: 62%

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Long‐term Oncologic Outcomes of 1188 Tis‐T2 Glottic Cancers Treated by Transoral Laser Microsurgery

Piazza¹,

Paderno²,

Bon³

et al. 2021

Otolaryngol.--head neck surg.

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Objective To evaluate long-term disease-specific survival (DSS) and organ preservation (OP) rates in patients affected by Tis-T2 glottic squamous cell carcinoma (SCC) treated by carbon dioxide transoral laser microsurgery (CO2 TOLMS). Study Design Single-center retrospective cohort study. Setting Tertiary academic hospital. Methods The study included patients treated by CO2 TOLMS for Tis-T2 glottic SCC at the Department of Otorhinolaryngology–Head and Neck Surgery of the University of Brescia, Italy, from 1988 to 2018. The male:female ratio was 11.2:1, and the mean age was 64 years (range, 31-95). T categories were distributed as follows: 124 (10%) Tis, 646 (54%) T1a, 172 (15%) T1b, and 246 (21%) T2. Results Ten- and 20-year DSS rates were 97.6% and 96.3%, respectively, and 10- and 20-year OP rates were 94.7% and 93%. During the follow-up, 91% of patients were treated by CO2 TOLMS alone, while the remaining needed adjunctive treatments. Assessing the impact of multiple sessions of CO2 TOLMS, DSS showed no significant difference in terms of patients treated by 1, 2, or >2 procedures. Conversely, patients treated by >2 sessions of CO2 TOLMS showed a significantly worse OP rate. Conclusions Our series validates CO2 TOLMS as a long-term treatment strategy for early glottic SCC. Salvage CO2 TOLMS provided optimal results in terms of DSS and OP in patients with recurrence after previous transoral surgery.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 62%

Long‐term Oncologic Outcomes of 1188 Tis‐T2 Glottic Cancers Treated by Transoral Laser Microsurgery

Piazza¹,

Paderno²,

Bon³

et al. 2021

Otolaryngol.--head neck surg.

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“…1 According to a study by Horwich et al, TLM does not result in a lower rate of locoregional control and overall survival of patients after total laryngectomy. 16 As per a study by Ahmed et al, KTP assisted TLM results in good functional outcomes. 1 It has been reported that for early lesions of the glottis, single modality treatment in the form of radiation or surgery offers comparable voice outcomes.…”

Section: Discussionmentioning

confidence: 81%

Role of lasers in glottic malignancies: our experience

Natarajan

Nandhan

Dham

et al. 2020

Int J Otorhinolaryngol Head Neck Surg

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Background: Laryngeal malignancy is one of the commonest head and neck cancers encountered in India. Most tumors are glottic in origin. Radiation, partial or total laryngectomy gives very good cure rates for these tumors. Lasers have emerged as an integral part of the treatment paradigm for patients with laryngeal cancer. Laser surgery is one of the primary treatment options for early-stage glottic tumors and can also be used for advanced laryngeal tumors. Methods: Fifty patients with laryngeal cancer were treated with laser over a 10-year period. Majority of patients were males with an average age of 46 years. Most patients had early (T1, T2) laryngeal malignancy (90%). There were a few patients with advanced laryngeal tumor (10%). All patients had tumor biopsy and simultaneous laserization of the tumor followed by radiation in T1 and T2 disease and chemo radiation in T3 disease. A few patients who had recurrence of disease after radiation (4%) were medically unfit for laryngectomy and underwent laserization of the tumor. Results: Laser surgery proved to be an important tool in the management of glottic tumors and is commonly utilized in the treatment of early-stage disease. It has also been successful for debulking of large tumors. Careful case selection is important for good outcomes. Conclusions: Transoral laser microsurgery and radiotherapy are useful treatment modalities in the management of early glottic malignancies. Lasers have proved to be effective in glottic malignancies with excellent oncologic and functional outcomes.

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“…A type V cordectomy may compromise the connective tissue barriers within the larynx, such as the conus elasticus, quadrangular membrane, ventricular connective tissue, and Broyles' ligament (commissural tendon) (16). Recurrent tumors could spread from the glottis to the supra/subglottis and paraglottic space, which have a more abundant lymph node basin (17).…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of risk factors for lymph node metastasis in recurrent glottic cancer after primary laser surgery: a cohort study from China

Chen¹,

Huang²,

Ding³

et al. 2022

Ann Transl Med

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Background: Although lymph node metastasis is a critical prognostic factor, the indications for neck dissection in recurrent glottic cancer after transoral laser microsurgery (TLM) are unclear. At present, there is no clear standard for simultaneous cervical lymph node dissection at home and abroad. Methods:We summarize the pattern of regional recurrence in glottic cancer after initial TLM and to evaluate the risk factors for neck metastasis. Seventy-five cases with recurrent glottic cancer after TLM between December 2004 and June 2014 were retrospectively analyzed. Survival, regional control rate, and neck metastasis were analyzed. The Kaplan-Meier method was used for survival analysis. Univariate analysis was performed with the log-rank test and multivariate analysis was completed using Cox regression. Results:The 5-year overall survival (OS), disease-specific survival (DSS), and regional control rate after the first TLM were 73.6%, 89.1%, and 69.7%, respectively. A total of 22 (29.3%) patients developed cervical metastases during long-term follow-up and showed a significant decline in OS and DSS rates. Multivariate analysis indicated that histological grading and type of TLM were both risk factors for neck metastasis.Patients treated with type Vc cordectomy were more likely to develop regional recurrence than patients treated with type III cordectomy [hazard ratio (HR) =14.737, 95% confidence interval (CI): 2.117-102.610, P=0.007]. No significant correlation was present between rT stage and neck metastasis.Conclusions: Multivariate analysis indicated that histological grading and type of TLM were both risk factors for neck metastasis. Patients with recurrence after type V cordectomy may have an increased risk of developing cervical lymph node metastasis, especially those with supraglottic spread or high-grade tumors.

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Laryngeal recurrence sites in patients previously treated with transoral laser microsurgery for squamous cell carcinoma

Cited by 10 publications

References 13 publications

Long‐term Oncologic Outcomes of 1188 Tis‐T2 Glottic Cancers Treated by Transoral Laser Microsurgery

Long‐term Oncologic Outcomes of 1188 Tis‐T2 Glottic Cancers Treated by Transoral Laser Microsurgery

Role of lasers in glottic malignancies: our experience

Retrospective analysis of risk factors for lymph node metastasis in recurrent glottic cancer after primary laser surgery: a cohort study from China

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