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Transoral laser microsurgery outcomes with early glottic cancer: the Dalhousie University experience

Published online by Cambridge University Press:  31 January 2011

S E Lester*
Affiliation:
Division of Otolaryngology Head and Neck Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
M H Rigby
Affiliation:
Division of Otolaryngology Head and Neck Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
S M Taylor
Affiliation:
Division of Otolaryngology Head and Neck Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
*
Address for correspondence: Mr Shane Lester, Consultant ENT Surgeon, Darlington Memorial Hospital, Darlington DL3 6HX, UK Fax: +44 (0)1325 743798 E-mail: [email protected]

Abstract

Objective:

To report the results of transoral laser microsurgery for the treatment of early glottic cancer at our institution.

Design:

Cohort study. Retrospective review of charts of patients diagnosed with tumour stage 1 or 2 (early stage; no nodes or metastases), previously untreated, primary glottic cancer, treated with transoral laser microsurgery at the Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada. The minimum follow-up period was two years.

Setting:

Tertiary care head and neck cancer centre.

Participants:

Fifty-three patients treated between January 2002 and November 2007.

Outcome measure:

Kaplan–Meier survival analysis for disease-free survival, overall survival and laryngectomy-free survival, at five years.

Results:

The group comprised 46 men and seven women, with a mean age of 66 years (range 30–84 years). Mean follow up was 40 months (range 12–89 months). There were four cases of complications (7.5 per cent). Kaplan–Meier survival analysis revealed a five-year disease-free survival (including salvage) of 96.2 per cent, a five-year overall survival (all causes) of 88.8 per cent and a five-year laryngectomy-free survival of 98.1 per cent.

Conclusion:

Transoral laser microsurgery is a safe and effective initial treatment for early laryngeal cancer, and has high rates of laryngeal preservation and disease-free survival.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Bradley, PJ, Mackenzie, K, Wight, R, Pracy, P, Paleri, V. Consensus statement on management in the UK: transoral laser assisted microsurgical resection of early glottic cancer. Clin Otolaryngol 2009;34:367–73CrossRefGoogle ScholarPubMed
2Pfister, DG, Laurie, SA, Weinstein, GS, Mendenhall, WM, Adelstein, DJ, Ang, KK et al. American Society of Clinical Oncology clinical practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer. J Clin Oncol 2006;24:3693–704CrossRefGoogle Scholar
3Dey, P, Arnold, D, Wight, R, Kelly, CG, McKenzie, K. Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancer. Cochrane Database Syst Rev 2002;(2):CD002027CrossRefGoogle ScholarPubMed
4Sjögren, EV, Langeveld, TPM, Baatenburg de Jong, RJ. Clinical outcome of T1 glottic carcinoma since the introduction of endoscopic laser surgery as treatment option. Head Neck 2008;30:1167–74CrossRefGoogle ScholarPubMed
5McCoul, ED, Har-El, G. Meta-analysis of impaired vocal cord mobility as a prognostic factor in T2 glottic carcinoma. Arch Otolaryngol Head Neck Surg 2009;135:479–86CrossRefGoogle ScholarPubMed
6Mendenhall, WM, Werning, JW, Hinerman, RW, Amdur, RJ, Villaret, DB. Management of T1-T2 glottic carcinomas. Cancer 2004;100:1786–92CrossRefGoogle ScholarPubMed
7Thurnher, D, Erovic, BM, Frommlet, F, Brannath, W, Ehrenberger, K, Jansen, B et al. Challenging a dogma – surgery yields superior long-term results for T1a squamous cell carcinoma of the glottic larynx compared to radiotherapy. Eur J Surg Oncol 2008;34:692–8CrossRefGoogle ScholarPubMed
8Schrijvers, ML, van Riel, EL, Langendijk, JA, Dikkers, FG, Schuuring, E, van der Wal, JE et al. Higher laryngeal preservation rate after CO2 laser surgery compared with radiotherapy in T1a glottic laryngeal carcinoma. Head Neck 2009;3:759–64CrossRefGoogle Scholar
9Hafidh, M, Tibbo, J, Trites, J, Corsten, G, Hart, RD, Nasser, J, et al. Radiotherapy for T1 and T2 laryngeal cancer: the Dalhousie University experience. Otolaryngol Head Neck Surg 2009;38:434–9Google ScholarPubMed
10Silver, CE, Beitler, JJ, Shaha, AR, Rinaldo, A, Ferlito, A. Current trends in initial management of laryngeal cancer: the declining use of open surgery. Eur Arch Otorhinolaryngol 2009;266:1333–52CrossRefGoogle ScholarPubMed
11Taylor, SM, Rigby, MH. Endoscopic treatment of Cis-T2 glottic cancer with a CO2 laser: 2-year survival analysis of 36 cases. J Otolaryngol Head Neck Surg 2008;37:582–5Google ScholarPubMed
12Cohen, SM, Garrett, CG, Dupont, WD, Ossoff, RH, Courey, MS. Voice-related quality of life in T1 glottic cancer: irradiation versus endoscopic excision. Ann Otol Rhinol Laryngol 2006;115:581–6CrossRefGoogle ScholarPubMed