Oncological outcomes of early stage glottic squamous cell carcinoma treated with transoral laser microsurgery

Am J Otolaryngol. 2020 Mar-Apr;41(2):102364. doi: 10.1016/j.amjoto.2019.102364. Epub 2019 Nov 28.

Abstract

Materials and methods: The records of patients treated with TLM with previously untreated early stage glottic squamous cell carcinoma were reviewed.

Results: A total of 201 patients were enrolled: 191 men (95.0%) and 10 women (4.98%). The anterior commissure (AC) was involved in 94 (47.8%) patients. The 3- and 5-year overall survival rates of all patients were 94.5% and 90.9%. The local recurrence rates were 30.8% in the AC involvement (AC+) group and 16.0% in the group without AC involvement (AC-). The mortality rates were 18.1% and 3.7% in the AC+ and AC- groups. The 3- and 5-year disease-free survival rates were lower in the AC+ group (89.1%, 82.5%) than that in AC- group (99.0%, 96.5%). Local recurrence rates were 25%, 22.7%, 23.4%, and 22.1% for Tis, T1a, T1b, and T2 lesions. The mortality rates were 0.0%, 4.6%, 12.8%, and 15.3%. Three- and 5-year disease-free survival rates did not differ significantly between the tumor stage subgroups. The mortality for patients with local recurrence was 22.2%, which was higher than that for those without recurrence. The organ preservation rate was 98.5%.

Purpose: This study was to assess the rates of oncological outcomes in patients with early stage glottic squamous cell carcinoma treated with transoral laser microsurgery (TLM).

Conclusion: AC involvement was a predictor of local recurrence, and its presence was associated with a reduced survival rate and increased mortality after TLM. TLM got high survival rate and low recurrence rate. The staging and oncological outcomes did not differ between tumor stage subgroups.

Keywords: Anterior commissure; Disease-free survival; Early stage squamous cell glottic carcinoma; Local recurrence; Transoral laser microsurgery.

MeSH terms

  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Humans
  • Laser Therapy / methods*
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Staging
  • Survival Rate
  • Tongue Neoplasms / mortality
  • Tongue Neoplasms / pathology
  • Tongue Neoplasms / surgery*
  • Transanal Endoscopic Microsurgery / methods*
  • Treatment Outcome