Results of 226 patients with T3 laryngeal carcinoma after treatment with transoral laser microsurgery

Head Neck. 2014 May;36(5):652-9. doi: 10.1002/hed.23338. Epub 2013 Jul 2.

Abstract

Background: The purpose of this study was to assess the feasibility of transoral laser microsurgery (TLM) in treatment of pT3 laryngeal cancer.

Methods: We conducted a retrospective case series study of 226 patients with pT3 glottic (n = 122; 54%) or supraglottic laryngeal carcinoma (n = 104; 46%). All patients were treated by TLM in combination with neck dissection (63%) and with postoperative radiotherapy (18%). Our main outcome measures were local control, organ preservation, functional outcome, overall survival, recurrence-free survival, and disease-specific survival.

Results: Median follow-up period was 57.8 months. The 5-year organ-preservation and local control rates for all patients were 87% and 71.4%, respectively. The 5-year overall, recurrence-free, and disease-specific survival were 64.4%, 63.0%, and 83.3%, respectively.

Conclusion: Results are comparable to partial or total laryngectomy, while being superior to primary chemo(radio)therapy. TLM results in low morbidity, rapid recovery, and good function and can be a valid option for organ-preserving surgery of pT3 glottic and supraglottic cancer.

Keywords: T3 laryngeal carcinoma; functional outcomes; oncologic results; organ preservation; transoral laser microsurgery.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Carcinoma, Squamous Cell / therapy
  • Chemoradiotherapy / methods*
  • Disease-Free Survival
  • Feasibility Studies
  • Female
  • Glottis / pathology
  • Glottis / surgery
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laryngeal Neoplasms / therapy
  • Laryngectomy / methods
  • Laser Therapy / methods*
  • Male
  • Microsurgery / methods
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Minimally Invasive Surgical Procedures / mortality
  • Neck Dissection / methods
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Staging
  • Organ Sparing Treatments
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Survival Rate
  • Treatment Outcome