Management of primary T1–T4 glottic squamous cell carcinoma by transoral laser microsurgery

Day, Andrew T.; Sinha, Parul; Nussenbaum, Brian; Kallogjeri, Dorina; Haughey, Bruce H.

doi:10.1002/lary.26207

Cited by 31 publications

(24 citation statements)

References 54 publications

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“…Similarly, the rate of laryngeal preservation in our study, as measured by a clinical course spared from total laryngectomy, is high. These rates are similar to those seen in other published studies examining CO 2 laser TLM for early glottic carcinoma, which are over 90% for both disease‐free and overall survival . To date, there have only been two other groups that have published on the oncological efficacy of KTP‐TLM versus EBRT, and our results confirm their findings as well .…”

Section: Discussionsupporting

confidence: 91%

Oncologic outcomes of KTP laser surgery versus radiation for T1 glottic carcinoma

et al. 2017

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Section: Discussionsupporting

confidence: 91%

Oncologic outcomes of KTP laser surgery versus radiation for T1 glottic carcinoma

et al. 2017

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“…Concerning oncological outcome a 6‐month observation would have been rather short. Day et al recently reported a rate of 5‐year local control of 83% in T1 glottic carcinoma using TLM‐CO 2 . Although our prospective trial was not powered to measure local control rate, we added a retrospective chart analysis after termination of the prospective trial.…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled single‐blinded clinical trial of functional voice outcome after vascular targeting KTP laser microsurgery of early laryngeal cancer

Strieth¹,

Ernst²,

Both³

et al. 2019

Head & Neck

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Background Local control rate (LCR) of early glottic cancer is high after radiation therapy or transoral laser microsurgery (TLM). The aim of this study was to investigate functional voice outcome after TLM using a microvessel‐ablative potassium‐titanyl‐phosphate (KTP) laser in comparison with a gold standard cutting CO2 laser. Methods The primary end point of this prospective, randomized, single‐blinded, clinical phase II study with control group was voice outcome during a follow‐up of 6 months assayed by Voice Handicap Index (VHI‐30)‐questionnaires in patients with unilateral high‐grade dysplasia, carcinoma in situ or early glottic cancer undergoing TLM‐KTP (n = 8) or TLM‐CO2 (n = 12). The secondary end point was LCR. Results Starting from the 9‐week‐follow‐up visit, TLM‐KTP yielded significantly reduced VHI scores compared to TLM‐CO2. No relapse occurred after TLM‐KTP in contrast to one recurrence after TLM‐CO2 within 6 months. Conclusion Multicenter phase II or III studies on voice outcome or local control rate after TLM‐KTP in early glottic cancer are warranted enrolling larger patient cohorts.

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“…Difficulties in exposure, positive margins, and low surgeon's experience have been mentioned as negative factors of local control. 11,20 In our center, margins are classified in 3 groups: affected, nonaffected, or uncertain. Piazza et al reported higher percentage of positive margins in T1-T2 tumors with unfavorable exposure during TLM.…”

Section: Technical Aspects Of the Surgerymentioning

confidence: 99%

Factors of local recurrence and organ preservation with transoral laser microsurgery in laryngeal carcinomas; CHAID decision‐tree analysis

et al. 2018

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Background Indications of transoral laser microsurgery (TLM) are conditioned by the risk of local relapse. Objective To evaluate prognostic factors of local relapse and local control with TLM (LC‐TLM). Methods Local relapse and LC‐TLM were evaluated in 1119 patients. Logistic regression and CHAID decision tree analysis were performed. Results Local relapse correlated to previous radiotherapy failure (8.45, CI 95%: 2.64‐27.03; P < .001), paraglottic involvement (2.42, CI: 1.41‐4.15; P = .001), anterior commissure involvement (2.12, CI: 1.43‐3.14; P < .001), grade of differentiation (1.74, CI: 1.18‐2.57; P = .005), and alcohol consumption (1.4, CI: 0.99‐1.98; P = .057). Local relapse tended to inversely correlate with experience (0.73, CI: 0.51‐1.03; P = .078). The most important factors for local relapse were previous radiotherapy failure and anterior commissure involvement. LC‐TLM inversely correlated with previous radiotherapy failure (0.09, CI: 0.03‐0.28; P < .001), paraglottic involvement (0.25, CI: 0.14‐0.43; P < .001), anterior commissure involvement (0.49, CI: 0.32‐0.77; P = .007), margins (0.56, CI: 0.30‐1.04; P = .068), and differentiation (0.68, CI: 0.44‐1.05; P = .087). LC‐TLM correlated with experience (1.71, CI: 1.13‐2.55; P = .010). The most important factors for LC‐TLM were previous radiotherapy failure and paraglottic involvement. Conclusion Previous radiotherapy failure is the most important factor for local relapse and LC‐TLM. In primary treatments, anterior commissure involvement and paraglottic involvement are the most important factors for local relapse and LC‐TLM, respectively.

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Management of primary T1–T4 glottic squamous cell carcinoma by transoral laser microsurgery

Abstract: 4 Laryngoscope, 127:597-604, 2017.

Cited by 31 publications

References 54 publications

Oncologic outcomes of KTP laser surgery versus radiation for T1 glottic carcinoma

Oncologic outcomes of KTP laser surgery versus radiation for T1 glottic carcinoma

Randomized controlled single‐blinded clinical trial of functional voice outcome after vascular targeting KTP laser microsurgery of early laryngeal cancer

Factors of local recurrence and organ preservation with transoral laser microsurgery in laryngeal carcinomas; CHAID decision‐tree analysis

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