Transoral carbon dioxide laser microsurgery for recurrent glottic carcinoma after radiotherapy

Abstract

In early-stage and advanced-stage recurrent glottic carcinomas after radiotherapy, CO(2) laser treatment can successfully be used as a curative organ-preserving procedure. Compared with salvage laryngectomy, results are superior with respect to preservation of laryngeal function. Great expertise is required, especially in resections of advanced-stage recurrent carcinomas.

Endoscopic Carbon Dioxide Laser Surgery for Glottic Cancer Recurrence After Radiotherapy

“…10,[23][24][25][26] Our experience of about 35% recurrence after salvage ELS is consistent with the rates published in previous studies. High recurrence rates after ELS are probably the result of understaging of the cancer both before radiotherapy and before ELS, which can lead to undertreatment and positive or close resection margins.…”

“…9 Recently, ELS has been used to remove small recurrences after radiation failure. 10 We performed a retrospective study to assess local control rates, organ preservation, and complications in patients who underwent ELS for glottic cancer recurrence after radiotherapy.…”

“…There are several advantages to using ELS for salvage surgery in recurrent laryngeal cancer compared with open conservative surgery, 10,[22][23][24][25][26] including shortened hospital stay with consequently reduced costs, low complication rate, possibility of avoiding tracheostomy, good functional results (especially in swallowing), and fewer [16][17][18][19][20][21][22] The reported rates for salvage ELS are as follows: local relapses, 6% to 59%; 3-year RFS, 91% to 100%; and preservation of larynx, 50% to 71%. 10,[23][24][25][26] Our experience of about 35% recurrence after salvage ELS is consistent with the rates published in previous studies.…”

Transoral resection of supraglottic tumours using microelectrodes (54 cases)

“…An interesting fact is that no significant differences in specific survival were found according to local recurrences. In glottic tumours similar criteria are followed; Steiner performed six total laryngectomies in 21 patients with anterior commissure involvement, in contrast to one total laryngectomy in a patient without anterior commissure involvement [10].…”

Supracricoid partial laryngectomies after radiation failure: A multi‐institutional series

“…[1][2][3] Local recurrence rate after radiation therapy (RT) ranges from 5% to 13% for T1 and from 25% to 30% for T2 laryngeal cancer. 4,5 Surgical management of recurrences after RT failure encompasses endoscopic laser excision, [6][7][8] partial laryngectomies through an open-neck approach, 4,[9][10][11][12][13] and total laryngectomy, which still remains the most widely used procedure in such a scenario.…”