Oncologic and functional outcomes of transoral CO2 laser cordectomy for early glottic cancer

Mundo, Daryl Anne A. Del; Morimoto, Koichi; Masuda, Kuriko; Iwaki, Shinobu; Furukawa, Tatsuya; Teshima, Masanori; Shinomiya, Hirotaka; Miyawaki, Daisuke; Otsuki, Naoki; Sasaki, Ryohei; Nibu, Ken‐ichi

doi:10.1016/j.anl.2019.08.005

Cited by 12 publications

(7 citation statements)

References 20 publications

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“…30 In cases of negative surgical margins, all authors suggest follow-up, except Preuss et al, 23 as aforementioned. However, several studies 7,13,19,22 have reported the possibility of local recurrence even in cases of negative resection margins. Based on this point of view, follow-up, preferably with narrow-band imaging (NBI), is important to detect early recurrence.…”

Section: Management Policies According To the Status Of The Resectionmentioning

confidence: 99%

“…However, other authors 6,10,12,13,22 always perform a close follow-up. Thus, in 2015, Hoffmann et al 12 achieved a 5-year OS in 79.2%, DSS in 91.5%, DFS in 61.7%, LP in 93.4%, and LC in 74.4% of their sample.…”

Section: Management Of Positive Surgical Marginmentioning

confidence: 99%

“…8,15,23 Some studies did not examine this kind of surgical-margin status, assessing only positive and negative ones. 10,12,13…”

Section: Management Of Close or Non-valuable Surgical Marginsmentioning

confidence: 99%

“…Based on this point of view, follow-up, preferably with narrow-band imaging (NBI), is important to detect early recurrence. 13,18 In fact, NBI is an endoscopic system that enables a better evaluation of the microvascular pattern in cases of preneoplastic and neoplastic lesions of the mucosa that cannot be examined with white-light endoscopy. 31 So, NBI enables the detection of the early recurrence of the tumor and its superficial extension, but cannot evaluate the depth of the infiltration.…”

Section: Management Policies According To the Status Of The Resection Marginsmentioning

confidence: 99%

“…The main disagreement in the literature is regarding the margin-to-tumor distance. Indeed, some authors suggest 2 mm as a safe distance, 7,10 while others consider 0.5 mm, 6,[11][12][13] and most suggest 1 mm. 8,[14][15][16] Moreover, the surgical margin is defined as non-valuable if laser artifacts such as carbonization make the assessment of the specimen's edge difficult.…”

Section: Introductionmentioning

confidence: 99%

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Management of Early Glottic Cancer Treated by CO2 Laser According to Surgical-Margin Status: A Systematic Review of the Literature

Verro

Greco

Chianetta

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Transoral laser microsurgery (TLM) is the treatment of choice for Tis-T2 squamous cell glottic carcinomas due to its advantages compared with open surgery and radiotherapy. However, the CO2 laser beam causes changes and damage on the specimens, making the histological assessment of resection margins, the gold standard for confirming radical tumor resection, sometimes difficult. Objective To assess the different ways to manage patients depending on the status of the histopathological margin according to recent studies to detect the most commonly shared therapeutic strategy. Data Synthesis We analyzed the literature available on the PubMed and Web of Science databases, including only articles published since 2005, using specific keywords to retrieve articles whose titles and abstracts were read and analyzed independently by two authors to detect relevant studies. Therefore, we focused on disease-free survival, overall survival, local control, laryngeal preservation, and disease-specific survival. Thus, 17 studies were included in the present review; they were grouped according to the status of the histological margin, and we analyzed the different management policies described in them. This analysis showed that there is not a shared strategy, though in most studies the authors performed a second-look surgery in the cases of positive margins and a close follow-up in cases of negative ones. The main disagreement is regarding the management of close or non-valuable resection margins, since some some authors performed a second-look surgery, and others, a close follow-up. Conclusions Definitely, the most shared policy is the second-look surgery in case of positive surgical margins, and a close follow-up in case of close or non-valuable resection margins. Key Points

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Section: Management Policies According To the Status Of The Resectionmentioning

confidence: 99%

Section: Management Of Positive Surgical Marginmentioning

confidence: 99%

“…8,15,23 Some studies did not examine this kind of surgical-margin status, assessing only positive and negative ones. 10,12,13…”

Section: Management Of Close or Non-valuable Surgical Marginsmentioning

confidence: 99%

Section: Management Policies According To the Status Of The Resection Marginsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management of Early Glottic Cancer Treated by CO2 Laser According to Surgical-Margin Status: A Systematic Review of the Literature

Verro

Greco

Chianetta

et al. 2020

Int Arch Otorhinolaryngol

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Voice quality after transoral CO2 laser microsurgery (TOLMS): systematic review of literature

Colizza

Ralli

D’Elia

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose Transoral laser microsurgery (TOLMS) with carbon dioxide is a safe approach for laryngeal carcinoma. In literature there are three main methods for evaluating speech outcomes: acoustic and aerodynamics analysis, perceptual evaluation and patient-reported outcomes (PROs). The aim of this study was to systematically review the literature about the voice quality outcomes of TOLMS according to type of cordectomy. Methods A systematic literature review was performed and all the results until December 2021 were extrapolated. We evaluated the acoustic and aerodynamics parameters (fundamental frequency, harmonics to noise ratio, jitter, shimmer and maximum phonation time), perceptual data (GRBAS scale) and patient-related outcomes (VHI scale). Results 24 studies met the inclusion criteria for a total number of 1207 patients enrolled. The number for each type of cordectomy are: 287 type I (23.78%), 311 type II (25.78%), 328 type III (27.14%), 129 type 4 (10.69%) and 152 type V (12.60%). Patients are grouped according to the type of cordectomy in: limited cordectomy (type I and II) and extended cordectomy (types III–IV–V). The difference between two groups is statistically significative in terms of acoustic analysis, perceptual data and patient-related outcomes (p < 0.05). Conclusions Patients who underwent type I or II cordectomy have significantly better quality of voice in terms of VHI, perceptual voice quality evaluations and acoustic parameters compared to type III, IV and V cordectomies. The effect of TOLMS on the voice should depend from the extent of the resection and in particular from the scar of the vocal muscle.

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Prognosis and Outcomes in Early Stage Glottic Carcinoma Involving the Anterior Commissure Treated with Laser CO2 Surgery: A Retrospective Observational Analysis

Carreras

Martínez-Torre

Zabaleta-López

et al. 2021

Indian J Otolaryngol Head Neck Surg

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Oncologic and functional outcomes of transoral CO2 laser cordectomy for early glottic cancer

Cited by 12 publications

References 20 publications

Management of Early Glottic Cancer Treated by CO2 Laser According to Surgical-Margin Status: A Systematic Review of the Literature

Management of Early Glottic Cancer Treated by CO2 Laser According to Surgical-Margin Status: A Systematic Review of the Literature

Voice quality after transoral CO2 laser microsurgery (TOLMS): systematic review of literature

Prognosis and Outcomes in Early Stage Glottic Carcinoma Involving the Anterior Commissure Treated with Laser CO2 Surgery: A Retrospective Observational Analysis

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