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Audit of transoral laser-assisted microsurgical resection of early laryngeal cancer

Published online by Cambridge University Press:  25 March 2015

I Amir  and
G A Vernham
I Amir*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, NHS Lothian, Edinburgh, Scotland, UK
G A Vernham
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, NHS Lothian, Edinburgh, Scotland, UK
*
Address for correspondence: Ms I Amir, Department of Otolaryngology and Head and Neck Surgery, Lauriston Building, Lauriston Place, Edinburgh EH3 9HA, Scotland, UK Fax: +44 131 536 3153 E-mail: [email protected]
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Abstract

Objective:

This study aimed to report our current practice of transoral laser microsurgery for early glottic cancer against the standards outlined by the ENT UK Head and Neck Group and assess the oncological outcome.

Method:

A retrospective review of case notes of patients diagnosed with early glottic cancer (tumour stages Tis, T1 and T2) who underwent transoral laser microsurgery as a primary curative treatment. The minimum follow-up period was two years.

Results:

Thirty-one patients had transoral laser microsurgery for early glottic cancer during the study period. Eighty-four per cent of cases were discussed by a multidisciplinary team prior to transoral laser microsurgery. Complete circumferential excision was achieved in 77 per cent of cases. Sixty-five per cent of specimens were subjected to histological analysis; they complied with standard pathology reporting for margins. Within 12 months of transoral laser microsurgery, there were 10 residual cases and 2 recurrences. Kaplan–Meier survival analysis gave disease-free survival rates of 96.8 per cent at 18 months and 93.5 per cent at 24 months. The laryngectomy-free survival rate was 96.8 per cent at two years.

Conclusion:

The findings of this audit are encouraging and have highlighted areas for further discussions, recommendations, training and education.

Keywords

Laryngeal NeoplasmsLaser Therapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 4 , April 2015 , pp. 372 - 376
Copyright
Copyright © JLO (1984) Limited 2015 

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References

1Pfister, D G, Laurie, S A, Weinstein, G S, Mendenhall, W M, Adelstein, D J, Ang, K K 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
2Mendenhall, W M, Werning, J W, Hinerman, R W, Amdur, R J, Villaret, D B. Management of T1-T2 glottic carcinomas. Cancer 2004;100:1786–92Google Scholar
3Bradley, P J, Mackenzie, K, Wight, R, Pracy, P, Paleri, V. On behalf of ENT-UK Head & Neck Group. Consensus statement on management in the UK: Transoral laser assisted microsurgical resection of early glottic cancer. Clin Otolaryngol 2009;34:367–73CrossRefGoogle Scholar
4Remacle, M, Van Haverbeke, C, Eckel, H, Bradley, P, Chevalier, D, Djukic, V et al. Proposal for revision of the European Laryngological Society classification of endoscopic cordectomies. Eur Arch Otorhinolaryngol 2007;264:499–504Google Scholar
5Kerr, P, Mark Taylor, S, Rigby, M, Myers, C, Osborn, H, Lambert, P, Sutherland, D, Fung, K. Oncologic and voice outcomes after treatment of early glottic cancer: transoral laser microsurgery versus radiotherapy. J Otolaryngol Head Neck Surg 2012;41:381–8Google ScholarPubMed
6Feng, Y, Wang, B, Wen, S. Laser surgery versus radiotherapy for T1-T2N0 glottic cancer: a meta-analysis. ORL J Otorhinolaryngol Relat Spec 2011;73:336–42CrossRefGoogle ScholarPubMed
7Mahler, V, Boysen, M, Brøndbo, K. Radiotherapy or CO(2) laser surgery as treatment of T(1a) glottic carcinoma? Eur Arch Otorhinolaryngol 2010;267:743–50Google Scholar
8Hamilton, D W, de Salis, I, Donovan, JL, Birchall, M. The recruitment of patients to trials in head and neck cancer: a qualitative study of the EaStER trial of treatments for early laryngeal cancer. Eur Arch Otorhinolaryngol 2013;270:2333–7CrossRefGoogle ScholarPubMed
9Steiner, W. Results of curative laser microsurgery of laryngeal carcinomas. Am J Otolaryngol 1993;14:116–21Google Scholar
10Karatzanis, A D, Psychogios, G, Zenk, J, Waldfahrer, F, Hornung, J, Velegrakis, G A et al. Comparison among different available surgical approaches in T1 glottic cancer. Laryngoscope 2009;119:1704–8Google Scholar
11Grant, D G, Salassa, J R, Hinni, M L, Pearson, B W, Hayden, R E, Perry, W C. Transoral laser microsurgery for carcinoma of the supraglottic larynx. Otolaryngol Head Neck Surg 2007;136:900–6Google Scholar
12Rubinstein, M, Armstrong, W B. Transoral laser microsurgery for laryngeal cancer: a primer and review of laser dosimetry. Lasers Med Sci 2011;26:113–24Google Scholar
13Murray, C E, Cooper, L, Handa, K K, MacLeod, T, MacKenzie, K. A technique for the orientation of endoscopically resected laryngeal lesions. Clin Otolaryngol 2007;32:201–3Google Scholar
14Walsh, J T Jr, Flotte, T J, Anderson, R R, Deutsch, T F. Pulsed CO2 laser tissue ablation: effect of tissue type and pulse duration on thermal damage. Lasers Surg Med 1988;8:108–18Google Scholar
15McClelland, L, Carr, E, Kamani, T, Cade, J, Young, K, Mortimore, S. Transoral laser microsurgery for early glottic cancer. ISRN Otolaryngol 2011;2011:750676Google Scholar
16Makki, F M, Rigby, M H, Bullock, M, Brown, T, Hart, R D, Trites, J et al. CO(2) laser versus cold steel margin analysis following endoscopic excision of glottic cancer. J Otolaryngol Head Neck Surg 2014;43:6Google Scholar
17Hakeem, A H, Tubachi, J, Pradhan, S A. Significance of anterior commissure involvement in early glottic squamous cell carcinoma treated with trans-oral CO2 laser microsurgery. Laryngoscope 2013;123:1912–17CrossRefGoogle ScholarPubMed
18Pearson, B W, Salassa, J R. Transoral laser microresection for cancer of the larynx involving the anterior commissure. Laryngoscope 2003;113:1104–12Google Scholar
19Rödel, R M, Steiner, W, Müller, R M, Kron, M, Matthias, C. Endoscopic laser surgery of early glottic cancer: involvement of the anterior commissure. Head Neck 2009;31:583–92Google Scholar
20Taylor, S M, Kerr, P, Fung, K, Aneeshkumar, M K, Wilke, D, Jiang, Y et al. Treatment of T1b glottic SCC: laser vs. radiation--a Canadian multicenter study. J Otolaryngol Head Neck Surg 2013;42:22Google Scholar
21Kerr, P, Mark Taylor, S, Rigby, M, Myers, C, Osborn, H, Lambert, P et al. Oncologic and voice outcomes after treatment of early glottic cancer: transoral laser microsurgery versus radiotherapy. Otolaryngol Head Neck Surg 2012;41:381–8Google ScholarPubMed
22Lee, H S, Chun, B G, Kim, S W, Kim, S T, Oh, J H, Hong, J C et al. Transoral laser microsurgery for early glottic cancer as one-stage single-modality therapy. Laryngoscope 2013;123:2670–4CrossRefGoogle ScholarPubMed
23Lester, S E, Rigby, M H, Taylor, S M. Transoral laser microsurgery outcomes with early glottic cancer: the Dalhousie University experience. J Laryngol Otol 2011;125:509–12Google Scholar