Surgical Therapy of T1 and Selected Cases of T2 Glottic Carcinoma: Cordectomy, Horizontal Glottectomy and CO₂ Laser Endoscopic Resection

Abstract

In our experience, although open laryngeal procedures can be still considered a valid option in the treatment of T1 and selected cases of T2 glottic carcinoma, endoscopic laser excision offered an oncologically adequate alternative to the traditional techniques, with minimum discomfort for the patient and satisfactory preliminary functional results.

Laser Surgery for T2 Glottic Carcinoma

“…For a long time, laser microsurgical treatment of T2 glottic carcinomas has been the central point of interest only in a few studies. In most of the publications, the results of conventional surgical therapy through an external approach were compared with the results of endoscopic laser therapy [10,11,[16][17][18]. Due to the fact that these studies were usually performed in a retrospective study design, there was always a debate about selection bias.…”

“…However, it could not be avoided that local recurrence occurred more often in groups that were treated by laser surgery [7,10,11,20]. It is interesting to notice that recurrent disease in cases of open partial resection most often occurs in the middle and posterior third of the vocal cord [21].…”

“…in T2 glottic carcinoma. In the attempt to answer this question, various studies have been performed in the past, usually in a retrospective study design [2,5,10,11]. The results of these studies have shown that the rate of recurrent disease following laser surgical resection of T2 glottic carcinoma is slightly less compared with primary radiotherapy and conventional surgical resection.…”

Treatment Outcome after Laser Excision of Early Glottic Squamous Cell Carcinoma&A Literature Survey

“…animal studies, studies on larger (T2-T4) carcinomas, meeting proceedings). Out of the remaining 235 references, 18 original papers on primary laser treatment of T1M0N0 glottic squamous cell carcinoma were identi ed (6,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Criteria for selection were: study population should only include primary T1N0M0 patients; the study population should be \ 10 patients; laser treatment should be the primary treatment; papers should be in English and recurrence rates or survival rates should be included.…”

Traditional transcutaneous approaches in head and neck surgery

“…A direct comparison of laser surgery and traditional open approaches is documented in 3 studies for tumor stages T1 and T2 [50], [51], [52]. There were no significant differences concerning survival rates, local control rates and the occurence of regional metastases postoperatively.…”