Oncological and functional outcomes of transoral laser surgery for laryngeal carcinoma

Pedregal‐Mallo, Daniel; Canteli, Mario Sánchez; López, Fernando; Álvarez-Marcos, César; Llorente, José Luís; Rodrigo, Juan P.

doi:10.1007/s00405-018-5027-z

Cited by 28 publications

(32 citation statements)

References 23 publications

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“…The respiratory, voice and swallowing functions, and long-term QoL are important in the treatment of early-stage GLC. The early-stage GLC without A-com infiltration treated by TLM cordectomy shows desired oncologic and functional results, and effect in equal to better results than the ones treated with radiotherapy (3,4). TLM (diode laser) microsurgery has an important place in the treatment of GLCs in recent years (19).…”

Section: Discussionmentioning

confidence: 99%

“…Since A-com is a site, where both vocal cords attach to the thyroid cartilage at the front and are, therefore, an area of perichondrium-free, it has an increased risk of tumor spread to the thyroid cartilage (3,32). But recently, some authors have reported that A-com involvement is independent of local recurrence (33).…”

Section: Discussionmentioning

confidence: 99%

“…In Turkey, 60% of LCs are glottic, 40% are supraglottic, and 1% are subglottic (2). The aim of surgery for LCs is to remove cancerous tissue and to maintain the laryngeal functions, such as speech, respiration, and swallowing as much as possible (3).…”

Section: Introductionmentioning

confidence: 99%

“…Today, radiotherapy (RT) and surgery are accepted as the methods of treatment used in early-stage GLCs. The surgical method is applied as endoscopic (accompanied with or without a transoral laser microscope) or open surgery (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

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Advantages of Transoral Endoscopic Diode Laser Microsurgery for the Treatment of Early-Stage Glottic Laryngeal Cancers

Resuli

Cansız

2020

Int J Cancer Manag

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Background: Transoral laser microsurgery (TLM) has become the preferred and standardized method for the early treatment of many laryngeal carcinomas, due to the good treatment results, together with the scarcity of local complications. Objectives: The aim of this study is to investigate the advantages of TLM (diode laser) in the treatment of patients with early-stage (T1-2) glottic laryngeal cancer (GLC). Methods: In the present study, 228 patients, who were diagnosed with early-stage GLC between 2007 and 2013 and treated with diode TLM in our clinic, were analyzed retrospectively. Results: During the 5-year follow-up period of the patients, it was found that 5.2% of the patients had therapeutic neck dissection and 2.6% had a tracheostomy. The mean hospitalization period was 24 hours and their speech and swallowing functions were satisfactory. Eight percent of the patients developed local relapse. In addition, the 5-year disease survival 100%, disease-free survival was 92%, and laryngeal preservation was 98.7%. Conclusions: The TLM method is a minimally invasive treatment for early-stage GLCs and gives treatment results similar to radiotherapy and open surgery methods. However, it is more advantageous than other methods in terms of reducing hospitalization period, low complication rate, preserving speech-swallowing functions, and its re-application in cases of relapse. TLM is a safe and reliable surgical technique with less morbidity that can be repeated in selected tumor recurrence. Anterior commissure monitoring must be important in the treatment of TLM. Especially in anterior commissure, tumors with a tendency to spread in the vertical plane should be monitored for local recurrence. Diode (gallium-arsenide) 980-nm laser has advantages over the standard CO2 laser, and TLM treatment stands out in early-stage GLCs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Advantages of Transoral Endoscopic Diode Laser Microsurgery for the Treatment of Early-Stage Glottic Laryngeal Cancers

Resuli

Cansız

2020

Int J Cancer Manag

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“…Its main advantages include avoiding tracheotomy and rapid recovery after the operation. [2][3][4][5][6] However, total vocal cord resection or resection of tissues beyond the vocal cord (type IV or V TLM) is required for cases of T3 glottic carcinoma, and such surgery results in substantial tissue defects. Although one side of the vocal cord is preserved, it cannot interact effectively with the contralateral tissue to produce phonatory vibration, which leads to unsatisfactory postoperative phonation.…”

Section: Introductionmentioning

confidence: 99%

Platysma skin flap: Laryngeal repair material to produce phonatory flap vibrational wave

Chen

Guan

et al. 2020

Head & Neck

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The platysma skin flap was used for laryngeal reconstruction after vertical partial laryngectomy to improve the postoperative voice quality of patients with T2 and T3 glottic laryngeal carcinoma. Sixty‐nine patients with unilateral T2 and T3 glottic laryngeal carcinoma were included. Forty‐six patients received vertical partial laryngectomy, and a platysma skin flap was used for laryngeal reconstruction. The other 23 patients underwent transoral laser microsurgery. Subjective and objective examinations were performed to evaluate laryngeal morphology after the surgery. Acceptable voice quality was achieved for 46 patients who underwent vertical partial laryngectomy. Flap vibrational waves occurred in 19 cases (41.3%). The platysma skin flap is an ideal tissue for the reconstruction of articulation structure in open surgery of T2 and T3 unilateral glottic laryngeal carcinoma.

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The impact of undergoing surgical margin evaluation during endoscopic surgery for early‐stage laryngeal squamous cell carcinoma

Gilja,

Kumar,

Vasan

et al. 2023

Head & Neck

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BackgroundThe impact of evaluating versus not evaluating surgical margins for early‐stage laryngeal squamous cell carcinoma (LSCC) has not been evaluated.MethodsOverall survival was compared between patients who underwent endoscopic surgery for cT1‐2, N0, M0 LSCC and had surgical margins evaluated versus not evaluated versus unevaluable in the National Cancer Database (2010–2019) using multivariable‐adjusted Cox proportional hazards analyses.Results7597 patients met study eligibility criteria. 4123 (54.3%) patients underwent margin evaluation, 1631 (21.5%) did not undergo margin evaluation, and 1843 (24.3%) had unevaluable margins. Patients undergoing margin evaluation had better overall survival than patients who did not undergo margin evaluation (HR: 0.88, 95% CI: 0.78–1.00, p = 0.044) and patients with unevaluable margins (HR: 0.88, 95% CI: 0.78–0.98, p = 0.021). Patients undergoing margin evaluation received significantly less adjuvant radiation.ConclusionsSurgical margin evaluation is an important prognostic factor for patients receiving endoscopic surgery for early‐stage LSCC and should be conducted whenever possible.

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Oncological and functional outcomes of transoral laser surgery for laryngeal carcinoma

Cited by 28 publications

References 23 publications

Advantages of Transoral Endoscopic Diode Laser Microsurgery for the Treatment of Early-Stage Glottic Laryngeal Cancers

Advantages of Transoral Endoscopic Diode Laser Microsurgery for the Treatment of Early-Stage Glottic Laryngeal Cancers

Platysma skin flap: Laryngeal repair material to produce phonatory flap vibrational wave

The impact of undergoing surgical margin evaluation during endoscopic surgery for early‐stage laryngeal squamous cell carcinoma

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