The role of primary transoral laser microsurgery in laryngeal cancer: a retrospective study.

Abstract

OBJECTIVE:

To investigate the oncologic and survival outcomes of primary transoral laser microsurgery in laryngeal cancer.

DESIGN:

Retrospective analysis of a database of all patients undergoing primary transoral laser microsurgery with or without adjunctive therapy from June 2000 to October 2013. The median follow-up time was 33 months.

SETTING:

A teaching hospital.

PARTICIPANTS:

Two hundred and three patients underwent primary transoral laser microsurgery. Of these, 166 had glottic and 37 had supraglottic squamous cell carcinoma.

MAIN OUTCOME MEASURES:

Overall survival, disease-specific survival, local control and rate of salvage laryngectomy.

RESULTS:

Primary transoral laser microsurgery was performed exclusively in 149 (73%) patients, 16 (8%) had transoral laser microsurgery followed by postoperative (chemo)radiotherapy, 6 (3%) had transoral laser microsurgery with neck dissection, and 32 (16%) had transoral laser microsurgery in combination with neck dissection and postoperative (chemo)radiotherapy. In glottic cancer, the 5-year local control was 86%, 86% and 76% in carcinoma in situ (Tis), early-stage (T1, T2) and late-stage (T3, T4) disease, respectively. The 5-year disease-specific survival was 93% in Tis, 96% in early-stage and 65% at late-stage disease. In supraglottic cancer, the 5-year local control was 66% in early-stage and 88% in late-stage disease. The 5-year disease-specific survival was 80% and 75%, respectively. The rate of salvage laryngectomy was 9.9%.

CONCLUSION:

In carefully selected patients with laryngeal cancer, primary transoral laser microsurgery with or without adjunctive therapy can be organ preserving. It can provide a valid treatment option for patients.

• Authors: K To, A Qureishi, S Mortimore, M De
• Journal: Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery (Clin Otolaryngol) Vol. 40 Issue 5 Pg. 449-55 (Oct 2015) ISSN: 1749-4486 [Electronic] England
• PMID: 25704647 (Publication Type: Journal Article)
• Copyright: © 2015 John Wiley & Sons Ltd.

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Squamous Cell (mortality, surgery)
• Databases, Factual
• Humans
• Kaplan-Meier Estimate
• Laryngeal Neoplasms (mortality, surgery)
• Laryngectomy
• Laser Therapy (methods)
• Microsurgery
• Middle Aged
• Postoperative Complications
• Retrospective Studies
• Salvage Therapy
• United Kingdom
• Young Adult