The role of primary transoral laser microsurgery in laryngeal cancer: a retrospective study. (October 2015)

• Record Type: Journal Article
• Authors: To, K.; Qureishi, A.; Mortimore, S.; De, M.
• Is Part Of: Clinical otolaryngology. Volume 40:Number 5(2015:Oct.)
• Page Start: 449
• Page End: 455
• Publication Date: 2015-10
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1111/coa.12397
• Languages: English
• ISSNs: 1749-4478

Abstract

<abstract abstract-type="main" id="coa12397-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="coa12397-sec-0001" sec-type="section"> <title>Objective</title> <p>To investigate the oncologic and survival outcomes of primary transoral laser microsurgery in laryngeal cancer.</p> </sec> <sec id="coa12397-sec-0002" sec-type="section"> <title>Design</title> <p>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.</p> </sec> <sec id="coa12397-sec-0003" sec-type="section"> <title>Setting</title> <p>A teaching hospital.</p> </sec> <sec id="coa12397-sec-0004" sec-type="section"> <title>Participants</title> <p>Two hundred and three patients underwent primary transoral laser microsurgery. Of these, 166 had glottic and 37 had supraglottic squamous cell carcinoma.</p> </sec> <sec id="coa12397-sec-0005" sec-type="section"> <title>Main outcome measures</title> <p>Overall survival, disease‐specific survival, local control and rate of salvage laryngectomy.</p> </sec> <sec id="coa12397-sec-0006" sec-type="section"> <title>Results</title> <p>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 <italic>in situ</italic> (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%.</p> </sec> <sec id="coa12397-sec-0007" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>