Negative pathology following endoscopic resection of T_1a squamous carcinoma of the glottis

Abstract

Endoscopic CO(2) laser excision for T(1a) glottic cancer is a recognized treatment modality producing equivalent disease-free and voice results to external beam radiotherapy. On reviewing a series of 15 patients who had undergone endoscopic resection of a T(1a) glottic squamous cancer, it was noted that five patients had negative excisional pathology following the initial biopsy of an invasive squamous carcinoma. The histopathology of each patient's resected specimen was reviewed by a second pathologist who confirmed the accuracy of the results in all cases. We conclude that a significant number of early squamous carcinomas of the glottis present with very small localized, minimally invasive disease and that a proportion may be treated by biopsy alone.

Functional organ preservation in laryngeal and hypopharyngeal cancer

“…In 39 (31%) patients no residual carcinoma was found in the laser resection specimen although clinical examination showed tissue proliferations suspicious for malignancy. Similar results were reported by Nassif et al [2] who found 33% (5 out of 15) resection specimens to be free of tumor after previous biopsy. These results show that a significant number of patients are inevitably overtreated when radiotherapy is the standard treatment protocol.…”

Assessment of Early Stage Glottic Cancer Depth of Resection After Transoral Laser Cordectomy

“…We found that 15 (46%) patients with proven CIS/T1a on biopsy had no residual carcinoma on final pathology specimen. These finding are higher than in other studies that reported 31% to 33% negative final pathology after positive biopsy 16 , 17 . One of the possible explanations is that the senior surgeon tends to perform excisional biopsy if that is possible.…”

The role of primary transoral laser microsurgery in laryngeal cancer: a retrospective study

“…Transoral laser microsurgery has additional advantages including voice and swallow preservation, avoidance of radiotherapy side‐effects, shorter hospital stay and up to fourfold reduction in costs . Interestingly, studies have shown that the initial biopsy in early glottic cancer often leads to complete tumour removal suggesting that patients are being over‐treated by RT . Moreover, the appearance of post‐irradiated tissue can lead to a delay in diagnosis of recurrence.…”