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

Ahmed, Jamal Uddin; Ibrahim, Amany; Freedman, L.M.; Rosow, David E.

doi:10.1002/lary.26853

Cited by 17 publications

(25 citation statements)

References 23 publications

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“…Short treatment duration, no risk of irradiation‐induced malignancy, the possibility of repetitive applications, and more remaining salvage options favor laser‐based TLM compared to RT especially in vocal fold leukoplakia . In a recent retrospective study, oncological outcome after TLM‐KTP and RT appears to be comparable in T1 glottic squamous cell carcinoma . In a small cohort of 20 patients with recurrent glottic cancer (rT1‐rT2), TLM‐KTP was even used as a salvage measure in failed RT .…”

Section: Discussionmentioning

confidence: 99%

“…42 In a recent retrospective study, oncological outcome after TLM-KTP and RT appears to be comparable in T1 glottic squamous cell carcinoma. 43 In a small cohort of 20 patients with recurrent glottic cancer (rT1-rT2), TLM-KTP was even used as a salvage measure in failed RT. 44 Although 80% of the treated patients were reported free of disease after 2 years, the concept of TLM-KTP should currently only be applied within GCP-ICH-conform clinical trials.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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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“…A, Well differentiated; B, moderately differentiated; C, poorly or undifferentiated; and D, differentiation unknown on <100 patients. [21][22][23][24] In a large meta-analysis that included 562 participants treated with laser surgery and 706 participants treated with radiotherapy, the pooled analysis showed that laser surgery significantly improved the overall survival of patients with T1 glottic carcinoma group. 25 In the current study, surgery yielded better survival than radiotherapy in patients with T1a stage glottis SCC, but not T1b, T1 not specified, or T2 stages.…”

Section: F I G U R Ementioning

confidence: 99%

Radiotherapy vs surgery for T1‐2N0M0 laryngeal squamous cell carcinoma: A population‐based and propensity score matching study

et al. 2018

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There are conflicting reports about whether radiotherapy or surgery is optimal for early‐stage laryngeal squamous cell carcinoma (LSCC), although both have recently been recommended. Patients with T1‐2N0M0 LSCC in the population‐based SEER database who underwent radiotherapy or surgery were reviewed. Propensity score matching was used to eliminate the baseline variations. After matching, 1913 pairs of patients were included. Overall, patients who received radiotherapy had worse cancer‐specific survival than patients with surgery. After stratification, the survival in patients who received radiotherapy was worse with respect to the following characteristics: ≤60 years of age; T1a glottis cancer; well‐differentiated tumors; and with married status. In other patients, survival outcomes were similar in patients who received radiotherapy and underwent surgery. Our results indicate that radiotherapy is not preferable in early‐stage LSCC patients who are ≤60 years of age, have T1a glottis cancer or well‐differentiated tumors, or are married. In other patients, both radiotherapy and surgery are comparable. However, our results cannot be a reference before controlled, prospective trials are performed.

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“…There are multiple options described in the literature for treating glottic carcinoma, and these consist of open surgery, TLM, or radiation. 1 There has been a transition from external surgery to endoscopic laser microsurgical techniques which have been possible mainly due to a landmark study by Professor Wolfgang Steiner (1993) and the European Laryngological Society's (ELS) classification scheme (2000). 5 TLM is the mainstay of treatment for early glottic carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…Glottic carcinoma is the most common subtype. 1 Treatment options include laser treatment, radiation, partial or total laryngectomy and in recent years, transoral robotic surgery.…”

Section: Introductionmentioning

confidence: 99%

Role of lasers in glottic malignancies: our experience

Natarajan

Nandhan

Dham

et al. 2020

Int J Otorhinolaryngol Head Neck Surg

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Background: Laryngeal malignancy is one of the commonest head and neck cancers encountered in India. Most tumors are glottic in origin. Radiation, partial or total laryngectomy gives very good cure rates for these tumors. Lasers have emerged as an integral part of the treatment paradigm for patients with laryngeal cancer. Laser surgery is one of the primary treatment options for early-stage glottic tumors and can also be used for advanced laryngeal tumors. Methods: Fifty patients with laryngeal cancer were treated with laser over a 10-year period. Majority of patients were males with an average age of 46 years. Most patients had early (T1, T2) laryngeal malignancy (90%). There were a few patients with advanced laryngeal tumor (10%). All patients had tumor biopsy and simultaneous laserization of the tumor followed by radiation in T1 and T2 disease and chemo radiation in T3 disease. A few patients who had recurrence of disease after radiation (4%) were medically unfit for laryngectomy and underwent laserization of the tumor. Results: Laser surgery proved to be an important tool in the management of glottic tumors and is commonly utilized in the treatment of early-stage disease. It has also been successful for debulking of large tumors. Careful case selection is important for good outcomes. Conclusions: Transoral laser microsurgery and radiotherapy are useful treatment modalities in the management of early glottic malignancies. Lasers have proved to be effective in glottic malignancies with excellent oncologic and functional outcomes.

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

Abstract: 4. Laryngoscope, 128:1052-1056, 2018.

Cited by 17 publications

References 23 publications

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

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

Radiotherapy vs surgery for T1‐2N0M0 laryngeal squamous cell carcinoma: A population‐based and propensity score matching study

Role of lasers in glottic malignancies: our experience

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