Oncological Results of Endoscopic Resections of Tis and T1 Glottic Carcinomas by Carbon Dioxide Laser

Abstract

A cohort of 88 patients with glottic cancer (13 Tis, 75 T1) who underwent endoscopic CO2 laser excision between January 1995 and June 1997 was prospectively studied. The mean follow-up was 43 months (range, 30 to 60 months). The depth and extent of the excision (graded according to the European Laryngological Society Classification, which includes 5 types of resection) were based on the results of a preoperative and intraoperative diagnostic test battery. Five patients died of other diseases, and none of glottic cancer. Of the 12 patients who developed a local recurrence, 5 underwent a second endoscopic procedure, 5 a total laryngectomy, and 1 a supracricoid laryngectomy, and 1 was treated with radiotherapy. The 5-year local control rate with endoscopic surgery alone, according to the Kaplan-Meier method, was 91%. None of the variables (8 related to the tumor and 2 to the treatment) tested in a univariate analysis by the log-rank test was found to have a significant impact on disease-free survival rates. The present study confirmed that endoscopic partial cordectomy for Tis and T1 glottic cancers can be regarded as a valid alternative to radiotherapy in terms of oncological results.

Transoral CO2 laser treatment for Tis–T3 glottic cancer: The University of Brescia experience on 595 patients

“…Indeed, anterior commissure involvement is not, in itself, a contraindication to an oncologically sound endoscopic approach when the lesion is limited to the glottic plane (T 1b ), as shown by the present data and those of other authors. 8,17,18 However, it may be contraindicated when the lesion crosses the anterior commissure in the vertical plane. In this case, the possible pathways of Table 3.…”

Endoscopic Excision with CO₂ Laser for the Treatment of Glottic Carcinomas

“…For some authors, there is a high risk of failure [9], and for others, there is no impact [10]. Like Peretti et al [7] and Remacle et al [5], we think that endoscopic treatment is limited to selected cases of AC cancer superficially spreading at the level of the glottis without deep extension.…”

“…Local control rates after CO 2 laser endoscopic excision are good, and frequently over 90% [7,8]. The most important limitation is anterior commissure (AC) involvement.…”

Diode Laser Microsurgery for Treatment of Early-Stage Glottic Cancers: Oncological Outcomes and Our Experiences

“…The early symptoms, easy diagnosis, and rare cervical lymph node involvement make the treatment of early-stage glottic cancer successful in most patients, and several treatments are currently available for these cancers (15). Of these, open partial surgery has several disadvantages, including postoperative complications such as pain, edema, subcutaneous emphysema, wound infection, and tracheotomy that necessitate a long length of stay in hospital and cause the deterioration of sound quality.…”