Transoral laser microsurgery as primary treatment for advanced‐stage oropharyngeal cancer: A united states multicenter study

TLDR

Advanced oropharyngeal cancers are often treated with non‑surgical modalities, yet these approaches yield only modest oncologic and functional outcomes. This study evaluates the outcomes of transoral laser microsurgery (TLM) as the primary treatment for advanced oropharyngeal carcinoma. A prospective multicenter cohort of 204 stage III–IV tonsil or tongue‑base patients treated with TLM from 1996–2006 was analyzed for survival, locoregional control, and swallowing status with at least two years of follow‑up. With a mean follow‑up of 49 months, 79.4 % of patients were alive, 3‑year overall, disease‑specific, and disease‑free survival rates were 86 %, 88 %, and 82 % respectively, local control was 97 %, and 87 % maintained normal swallowing or only episodic dysphagia. © 2011 Wiley Periodicals, Inc.

Abstract

Abstract Background Nonsurgical modalities are sometimes advocated as the standard of care for advanced oropharyngeal tumors. Oncologic and functional results have been modest. The aim of our study was to evaluate outcomes of a minimally invasive approach, using transoral laser microsurgery (TLM) as the primary treatment for advanced oropharyngeal carcinoma. Methods A prospectively assembled database of 204 patients with American Joint Committee on Cancer (AJCC) stages III and IV tonsil or tongue base cancer, treated primarily with TLM during 1996–2006 at 3 centers with minimum 2‐year follow‐up was analyzed. Survival, locoregional control, and swallowing status were recorded. Results Mean follow‐up was 49 months and 79.4% of patients were alive. Three‐year overall survival, disease‐specific survival, and disease‐free survival were 86%, 88%, and 82%, respectively. Local control was 97%, and 87% of patients had normal swallowing or episodic dysphagia. Conclusions TLM as a primary treatment for advanced oropharyngeal malignancy confers excellent survival and swallowing proficiency. © 2011 Wiley Periodicals, Inc. Head Neck, 2011