Outcome of transoral laser microsurgery for T2‐T3 tumors growing in the laryngeal anterior commissure

Abstract

TLM is a useful treatment for T2 to T3 laryngeal carcinomas growing in the laryngeal anterior commissure when it is performed under an advanced learning curve.

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

“…In case of laryngeal tumours involving or originating from the anterior commissure (AC), difficulties in treatment could be related to tumour exposure and technical limitations of lack of perpendicular laser tool, which could be minimised by an enlarged resection and advanced surgical experience with TLM which allow the achievement of comparable oncologic and functional results with low morbidity [24,34].…”

The learning curve in transoral laser microsurgery for malignant tumors of the larynx and hypopharynx: parameters for a levelled surgical approach

“…In locally advanced tumors and stage III tumors, a statistically significant difference was found in the diseasespecific survival rates on favor of more experienced surgeons [8]. Thus, the recommendation for TLM ''beginners'', even when experienced in external approaches, is to first accumulate experience with early tumors.…”

“…However, it is not that they were directly scheduled for TLM of large tumors, but rather due to the fact that most T3 and some T4 tumors were assessed as such during surgery, having failed the preoperative assessment. As reported by us recently [8], preoperative CT of the larynx provided an understaging particularly of T3/T4 up to a 40 % (when, e.g., a focal erosion of the thyroid cartilage was found during surgery, then staged as T4 before the 2002 TNM classification).…”

“…Additional parameters might be helpful to assess the grade of expertise predicting, e.g., its potential influence on the complication rate or even the survival outcome. In a previous study, we could show the grade of expertise to have a significant influence on the disease-specific survival in advanced tumors involving the anterior commissure treated with TLM [8]. It seems necessary to define these new parameters as, contrary to surgical techniques such as those on chronic sinusitis, TLM addresses oncological patients.…”

Acta Otorhinolaryngologica Italica

“…Indeed, the oncological radicality of SPL in selected locally advanced LSCC is increasingly being confirmed in the recent literature 13 - 15 . The main advantage of TLM seems to be linked to the possibility of treating LSCC without excluding further therapeutic options in cases of new recurrences 2 16 17 . Furthermore TLM is repeatable in the case of local early recurrence 18 .…”