Transoral laser microsurgery for early glottic cancer as one‐stage single‐modality therapy

Abstract

OBJECTIVES/HYPOTHESIS: A study was undertaken to determine the oncologic outcomes in a consecutive series of early glottic carcinomas treated with transoral CO₂ laser microsurgery (TLM) as a one-stage single-modality therapy, without any postoperative radiation therapy or retreatment with laser. We further evaluated correlations between the oncologic outcomes and clinicopathologic factors including tumor location and surgical margin. STUDY DESIGN: Retrospective analysis of medical records. METHODS: The medical records of 118 consecutive patients with early stage (T1, T2) glottic carcinoma who underwent TLM by a single surgeon as an initial treatment from 1997 to 2011 were retrospectively reviewed. The oncologic outcomes were evaluated, and correlations to clinicopathologic factors were analyzed. RESULTS: The 5-year disease-free survival, ultimate local control with laser alone, disease-specific survival, overall survival, and organ preservation rates were 87.9%, 94.2%, 99.0%, 92.2%, and 96.2%, respectively. Neither the reported surgical margin nor the extension of tumor to the anterior commissure, arytenoid, subglottis, and ventricle showed any significant impact on local control or survival. CONCLUSIONS: Transoral CO₂ laser microsurgery as one-stage single-modality therapy resulted in a high rate of local control and a high survival rate in selected cases of early glottic carcinoma, regardless of the location of tumor and histopathology report on the surgical margin.