Long-term Voice Outcome Following Radiation Versus Laser Microsurgery in Early Glottic Cancer

Ma, Yue; Green, Rebecca; Pan, Stephanie; McCabe, Daniel J.; Goldberg, Leanne; Woo, Peak

doi:10.1016/j.jvoice.2017.10.018

Cited by 24 publications

(23 citation statements)

References 25 publications

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“…It is especially superior to open surgeries in early GLCs and is preferential (20). The sound quality is highly maintained in the TLM method and no tracheostomy is performed unless it is compulsory (11,12,21). In addition, recent studies have revealed that TLM has yielded good survival results in the treatment of early-stage GLCs at least open surgery and RT do (90% -95%) (21-23).…”

Section: Discussionmentioning

confidence: 99%

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Advantages of Transoral Endoscopic Diode Laser Microsurgery for the Treatment of Early-Stage Glottic Laryngeal Cancers

Resuli

Cansız

2020

Int J Cancer Manag

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Background: Transoral laser microsurgery (TLM) has become the preferred and standardized method for the early treatment of many laryngeal carcinomas, due to the good treatment results, together with the scarcity of local complications. Objectives: The aim of this study is to investigate the advantages of TLM (diode laser) in the treatment of patients with early-stage (T1-2) glottic laryngeal cancer (GLC). Methods: In the present study, 228 patients, who were diagnosed with early-stage GLC between 2007 and 2013 and treated with diode TLM in our clinic, were analyzed retrospectively. Results: During the 5-year follow-up period of the patients, it was found that 5.2% of the patients had therapeutic neck dissection and 2.6% had a tracheostomy. The mean hospitalization period was 24 hours and their speech and swallowing functions were satisfactory. Eight percent of the patients developed local relapse. In addition, the 5-year disease survival 100%, disease-free survival was 92%, and laryngeal preservation was 98.7%. Conclusions: The TLM method is a minimally invasive treatment for early-stage GLCs and gives treatment results similar to radiotherapy and open surgery methods. However, it is more advantageous than other methods in terms of reducing hospitalization period, low complication rate, preserving speech-swallowing functions, and its re-application in cases of relapse. TLM is a safe and reliable surgical technique with less morbidity that can be repeated in selected tumor recurrence. Anterior commissure monitoring must be important in the treatment of TLM. Especially in anterior commissure, tumors with a tendency to spread in the vertical plane should be monitored for local recurrence. Diode (gallium-arsenide) 980-nm laser has advantages over the standard CO2 laser, and TLM treatment stands out in early-stage GLCs.

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Section: Discussionmentioning

confidence: 99%

“…TLM shows good oncologic and survival results, as well as open surgery and RT. As another important advantage of TLM, it presents the possibility of laser, open partial surgery, or RT in patients with local recurrence or second primary tumor in the head and neck region (6,8,(11)(12)(13)(14)(15)).…”

Section: Introductionmentioning

confidence: 99%

Advantages of Transoral Endoscopic Diode Laser Microsurgery for the Treatment of Early-Stage Glottic Laryngeal Cancers

Resuli

Cansız

2020

Int J Cancer Manag

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“…A number of studies have been conducted to determine voice quality of patients with early glottic cancer after RT and LC. Most of these studies focused on voice acoustic analysis, psychoacoustic analysis using GRBAS scale with analysis of voice handicap index, and comparison of quality of life after surgery [16]. However, in previous studies, no significant differences in F0, jitter, or shimmer were found, although MPT was slightly longer in the RT group than that in the LC group [7,8].…”

Section: Discussionmentioning

confidence: 99%

“…The difference in MPT and shimmer between the two groups suggests that patients who have received RT might have better voice than those who have received LC. A study comparing voice handicap index and the quality of life has shown that the group that underwent LC has statistically better results [15,16]. In addition, the LC group showed similar MPT and acoustic parameters to the normal group and voice after LC was similar to that after RT.…”

Section: Discussionmentioning

confidence: 99%

“…With respect to GRBAS of perceptual analysis, Czecior et al [11] and Sjogren et al [14] have shown no significant differences between the two treatments. However, Ma et al [16] found that patients treated with RT exhibited greater roughness and strain than patients treated with LS, although no differences in breathiness or asthenia were noted. Aaltonen et al [15] found that RT results showed statistically significant differences in B and A than transoral LS, although G, R, and S were similar between the two treatment groups.…”

Section: Discussionmentioning

confidence: 99%

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Perceptual and Acoustic Outcomes of Early-Stage Glottic Cancer After Laser Surgery or Radiotherapy: A Meta-Analysis

Lee

Hong

Kim

2019

Clin Exp Otorhinolaryngol

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Laser surgery (LS) or radiotherapy (RT) is normally recommended in early glottic cancer. The objective of this study was to perform a comprehensive meta-analysis of acoustic and perceptual outcomes to compare voice quality of LS or RT in early-stage glottic cancer. Data sources were obtained after searching PubMed, Google Scholar, EBSCO, and RISS using the following search terms: glottic cancer, glottic carcinoma, endoscopic surgery, laser surgery, radiotherapy, radiation, voice, voice quality, and grade, roughness, breathiness, asthenia, and strain (GRBAS) scale. Articles that compared voice outcomes between LS and RT were identified. This meta-analysis included 15 articles with 744 patients, including 400 in the LS group and 344 in the RT group. Random effects models were selected. Forest plots included standardized mean differences, standard errors, variance, 95% confidence intervals (lower limit to upper limit), z-values, and P -values. In perceptual analysis, grade (G) and asthenia (A) of RT were significantly better than LS. There was no statistically significant difference in roughness (R), breath (B), or strain (S) between LS and RT groups. Jitter, shimmer, and noise to harmonic ratio measurements showed significant differences, resulting in enhanced posttreatment effect of RT compared to LS. Results of our meta-analysis suggested that RT might lead to superior voice quality than LS in early glottic cancer.

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Describing, Assessing, and Treating Voice Disorders

Morris

Harmon

2021

The Handbook of Language and Speech Disorders

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Long-term Voice Outcome Following Radiation Versus Laser Microsurgery in Early Glottic Cancer

Cited by 24 publications

References 25 publications

Advantages of Transoral Endoscopic Diode Laser Microsurgery for the Treatment of Early-Stage Glottic Laryngeal Cancers

Advantages of Transoral Endoscopic Diode Laser Microsurgery for the Treatment of Early-Stage Glottic Laryngeal Cancers

Perceptual and Acoustic Outcomes of Early-Stage Glottic Cancer After Laser Surgery or Radiotherapy: A Meta-Analysis

Describing, Assessing, and Treating Voice Disorders

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