Transoral Laser Surgery for Early Glottic Cancers

Abstract

Transoral laser surgery is an oncologically safe, function-preserving modality for treatment of early glottic cancers.

CO2 laser cordectomy for glottic squamous cell carcinoma involving the anterior commissure: voice and oncologic outcomes

“…This contrary local recurrence trend may represent limitations in the current clinical staging systems to account for the local aggressiveness of glottic SCC. Additional studies evaluating endoscopic cordectomy of have reported similar oncologic success rates comparative with the present study [1,2]. Although oncologic outcomes are poorer in SCC with AC-involvement as compared with SCC without AC-involvement, CO 2 laser cordectomy continues to demonstrate excellent local control and laryngeal preservation rates as compared with the other therapeutic options of radiation therapy [16] and open surgery [15,17].…”

“…While the pathophysiologic basis for the increased aggressiveness of this laryngeal cancer subsite requires further study, the published clinical experience regarding the treatment outcomes for SCC involving the AC is limited. In particular, the published endoscopic CO 2 laser cordectomy experience to date has typically reported either oncologic outcomes [1][2][3] or voice outcomes with quality of life descriptions [4]. However, when evaluating the treatment recommendations for AC carcinomas consideration of both oncologic and voice outcomes is required and little is currently known regarding the oncologic and voice outcomes within a single patient cohort [5].…”

Higher laryngeal preservation rate after CO2 laser surgery compared with radiotherapy in T1a glottic laryngeal carcinoma

“…In the literature, local control rates for radiotherapy are reported between 78% and 94% 10,15,16 and for CO 2 laser surgery between 77% and 95%. 4,[8][9][10]17 Our 5-year local control rates are somewhat lower than the local control rates found in the literature. A possible explanation might be that other authors reported a 3-year local control rate and included Tis carcinomas in their group.…”

“…A possible explanation might be that other authors reported a 3-year local control rate and included Tis carcinomas in their group. 4,8,17 In the current study, we showed that patients with T1a glottic laryngeal carcinoma treated primarily with CO 2 laser surgery had a significantly better 5-year laryngeal preservation rate (95%) than patients treated with radiotherapy (77%), despite the lack of difference in local control. For the CO 2 laser group, our 5-year laryngeal preservation rate is in concordance with previously published results.…”

“…Clinical outcome in early-stage glottic carcinoma (local control, survival, and laryngeal preservation) are reported to be similar with both treatment modalities. [4][5][6][7][8] At the University Medical Center Groningen (UMCG), a tertiary referral hospital, CO 2 laser surgery has been increasingly applied as the treatment of first choice for T1a glottic laryngeal carcinoma with normal or diminished mucosal wave indicating superficial tumor growth. Radiotherapy used to be the treatment of first choice.…”