Laser surgery for early to moderately advanced glottic, supraglottic, and hypopharyngeal cancers

Abstract

Current practice standards for the treatment of early to moderately advanced laryngeal and hypopharyngeal cancer demand both achievement of cure and preservation of laryngeal structure and function to the greatest extent possible. The oncologic and functional results of transoral laser microsurgery (TLM) for early glottic cancer appear to be comparable to those of radiotherapy, with a higher rate of laryngeal preservation and a lower cost. TLM for early and moderately advanced supraglottic and hypopharyngeal cancers offers similar results with regard to survival and local control to those obtained with open surgical approaches. In addition, functional results of TLM are superior to those of open approaches because tracheotomies are usually avoided, rehabilitation of swallowing is faster, and hospital stay is shorter. TLM, when applicable, has become the preferred modality for surgical treatment of most early to moderately advanced cancers of the larynx and selected tumors of the hypopharynx.

Factors of local recurrence and organ preservation with transoral laser microsurgery in laryngeal carcinomas; CHAID decision‐tree analysis

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] In series with T1 midcord tumors the risk of local relapse is usually under 6%. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] In series with T1 midcord tumors the risk of local relapse is usually under 6%.…”

Conservative treatment for advanced T3–T4 laryngeal cancer: meta-analysis of key oncological outcomes

“…In general, there has been a move from surgery towards chemoradiation therapy in the management of advanced laryngeal cancer patients, in attempt to preserve laryngeal functions; however, nonsurgical preservation approach do not offer a survival advantage compared to TL [14], and due to the evidence of objective failures of preservation laryngeal protocols [44][45][46][47][48][49][50], conservative surgery has been increasingly considered for selected tumours [51].…”

Transoral robotic surgery versus conventional surgery in treatment for squamous cell carcinoma of the upper aerodigestive tract

“…For conventional surgery, published findings confirm a much longer duration of feeding by NG tube than for endoscopic surgery. This duration varies between 15 and 20 days, depending on tumor location and patient history (including history of radiotherapy in particular) . TLM results are equivalent to those for TORS in terms of the durations of hospitalization and NG tube feeding …”