Transoral Laser Microsurgery vs Radiotherapy for Early Glottic Cancer: Study at Tertiary Care Center in India

Abstract

Aim:To compare laryngeal preservation rates, survival rates, and voice outcomes after treatment of early glottic cancer between transoral laser microsurgery (TLM) and radiotherapy (RT). Materials and methods:A review of oncologic results was performed on a consecutive series of individuals with early-stage glottic carcinoma (T1 and T2) who were treated between 2011 and 2014 at Kidwai Memorial Institute of Oncology and had received either RT or TLM. Data were collected with a view to assess overall survival, disease-specific survival, laryngectomyfree survival, and laryngeal preservation rates. The Voice Handicap Index-30 (VHI-30) was used as the measure of voice quality after treatment. Results:Two-year overall survival for TLM group was 93.8% and for RT group was 90.5%, p = 0.643. Disease-free survival (TLM = 90.6% vs RT = 76.2%) was not found to be significant (p-value = 0.104). Laryngeal preservation rate was 79.5% in TLM and 71.4% in RT group (p-value = 0.003). Laryngectomyfree survival was better in TLM (TLM = 96.9% vs RT = 76.2%, p = 0.003). Substage analysis showed equivalent voice for TLM (VHI = 6-12) and RT (VHI = 6-14) in T1a patients (p = 0.94), whereas voice outcome was better for RT in T1b (VHI = 10-16 for TLM vs VHI = 11-18 for RT, p = 0.044) and T2 (VHI = 21-29 for TLM vs VHI = 16-23 for RT, p = 0.002) stages. Conclusion:Transoral laser microsurgery can be considered the treatment of choice for early glottic cancer in view of better IJHNS

Treatment of Early Glottic Carcinoma with Transoral Endoscopic Laser Surgery

“…Modern CO 2 lasers are precise and capable of good intraoperative hemostasis. It is possible to repeat laser resection on case of positive or uncertain margin 2,3 .…”