Transoral laser microsurgery outcomes with early glottic cancer: the Dalhousie University experience

J Laryngol Otol. 2011 May;125(5):509-12. doi: 10.1017/S002221511000304X. Epub 2011 Jan 31.

Abstract

Objective: To report the results of transoral laser microsurgery for the treatment of early glottic cancer at our institution.

Design: Cohort study. Retrospective review of charts of patients diagnosed with tumour stage 1 or 2 (early stage; no nodes or metastases), previously untreated, primary glottic cancer, treated with transoral laser microsurgery at the Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada. The minimum follow-up period was two years.

Setting: Tertiary care head and neck cancer centre.

Participants: Fifty-three patients treated between January 2002 and November 2007.

Outcome measure: Kaplan-Meier survival analysis for disease-free survival, overall survival and laryngectomy-free survival, at five years.

Results: The group comprised 46 men and seven women, with a mean age of 66 years (range 30-84 years). Mean follow up was 40 months (range 12-89 months). There were four cases of complications (7.5 per cent). Kaplan-Meier survival analysis revealed a five-year disease-free survival (including salvage) of 96.2 per cent, a five-year overall survival (all causes) of 88.8 per cent and a five-year laryngectomy-free survival of 98.1 per cent.

Conclusion: Transoral laser microsurgery is a safe and effective initial treatment for early laryngeal cancer, and has high rates of laryngeal preservation and disease-free survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Carcinoma / surgery*
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Glottis
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Lasers, Gas
  • Male
  • Microsurgery / adverse effects
  • Microsurgery / methods*
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasms, Second Primary / epidemiology
  • Patient Preference
  • Radiotherapy, Adjuvant
  • Treatment Outcome
  • Voice Quality