CO2 laser surgery for the treatment of glottic cancer
DOI:
https://doi.org/10.34631/sporl.193Keywords:
glottic cancer, transoral CO2 laser microsurgery, anterior commissure, margin statusAbstract
Introduction: Transoral laser microsurgery (TLM) can be
considered a valid alternative in the treatment of glottic
cancer.
Matherial and Methods: Retrospective study, considering all
patients treated with TLM, from January 2000 to December
2005. Patients were considered for the present study if they
underwent laser surgery as primary treatment of glottic
cancer.
Results: 45 patients: CIS (n=9), T1a (n=29), T1b (n=5), T2
(n=1), T3 (n=1). The mean duration of follow-up was 63,3
months. The rate of global local recurrence was 22,2%, with
the anterior commissure involvement being responsible for
40% of the recurrences. The 5-year overall survival and the
5-year disease-free survival were 82,2%, and the laryngeal
preservation rate was 89,2%.
Conclusion: This study supports the role of TLM in treating
early-stage glottic cancer. The highest recurrence rates occur
with positive margins and anterior commissure involvement.
Advanced glottic cancers are not a consensual indication for
laser surgery, usually with worse oncological outcome.
References
Sigston E, Mones E, Babin E, Hans S et al. Early-stage gllotic cancer – Oncological results and margins in laser cordectomy. Arch Otolaryngol Head and Neck Surgery. 2006 Fev; 132:147-152.
Bocciolini C, Presutti L, Laudadio P. Oncological outcome after CO2 laser cordectomy for early-stage glottis carcinoma. Acta Otorhinolaryngol Ital. 2005; 25:86-93.
Llames AP, Batalla FN, Pendás JLL, Vérez MP et al. Laser cordectomies: outcomes and funcional results. Acta Otorrinilaringol Esp 2004;55:34-40.
Hinni ML, Salassa JR, Grant DG, Steiner W et al. Transoral laser microsurgery for advanced laryngeal cancer. Arch Otolaryngol Head and Neck Surgery 2007; 133(12):1198-1204.
Shapshay SM, Hybels RL, Bohigian RK. Laser excision of early vocal cord carcinoma: indications, limitations and precautions. Ann otol Rhinol Laryngol 1990;99:46-50.
Eckel HE, Thumfart WF. Laser surgery for the treatment of larynx carcinomas: indications, techniques and preliminary results. Ann otol Rhinol Laryngol 1992;101: 113-118.
Casiano RR, Cooper JD, Lundy DS, Chandler JR. Laser cordectomy for T1 glottic carcinoma: a 10-year experience and videostroboscopic findings. Otolaryngology Head and Neck Surgery. 1991 Jun; 104(6):831-837.
Chone CT, Yonehara E, Martins JEF, Altemani A et al. Importance of anterior comissure in recurrence of early glottis cancer after laser endoscopic resection. Arch Otolaryngol Head and Neck Surgery. 2007 Set; 133(9):882-887.
Herranz J, Gavilán J, Vázquez-Barros J. Review article: Carcinoma of the anterior comissure. Acta Otorrinilaringol Esp 2007; 58(8):367-370.
Ansarin M, Santoro L, Cattaneo A, Massaro MA et al. Laser Surgery for early glottis cancer: impact of margin status on local control and organ preservation. Arch Otolaryngol Head and Neck Surgery. 2009;135(4):385-390.
Huang Z, Han D, Wang T, Yu Z et al. Brief report: Oncological outcome of CO2 laser surgery for glottis carcinoma. Chin Med J 2006;119(6):510-513.
Cruz MF, Olias J, Santiago N. Tratamento das lesões pré-malignas e malignas glóticas com cirurgia laser CO2 – resultados após 7 anos de experiência. Otorrinolaringologia e Cirurgia Cervico-Facial. 1999; 37(3):209-217.
Rodrigo JP, Coca-Pelaz A, Suárez C. El papel de la cirurgia parcial como estratégia de preservación en el carcinoma de laringe. Acta Otorrinilaringol Esp 2010;155:85-93.
Murty GE, Diver JP, Bradley PJ. Carcinoma in situ of the glottis: radiotherapy or excision biopsy? Ann otol Rhinol Laryngol 1993;102: 592-595.
Eckel HE, Perretti G, Remacle M, Werner J. Endoscopic approach. Springer (Eds.). Surgery of Larynx and Trachea. Berlin, 2010: pp197-214.
Steiner W, Ambrosch P. Endoscopic microsurgical laser treatment of malignant diseases of the upper aerodigestive tract. Thieme (Eds.). Endoscopic laser surgery of the upper aerodigestive tract. New-York. 1997: pp33-82.
