Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-24T04:28:42.205Z Has data issue: false hasContentIssue false

Outcomes of transoral laser microsurgery for recurrent head and neck cancer

Published online by Cambridge University Press:  07 October 2013

L F Reynolds
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
M H Rigby
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
J Trites
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
R Hart
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
S M Taylor*
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
*
Address for correspondence: Dr S M Taylor, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada Fax: 001 902 473 4016 E-mail: [email protected]

Abstract

Objective:

To report our outcomes with salvage CO2 laser surgery following recurrence of laryngeal and oropharyngeal cancer after radiotherapy.

Method:

This study entailed a prospective review of patients treated with transoral laser microsurgery for recurrent laryngeal and oropharyngeal cancer between 2002 and 2010 at the Queen Elizabeth II Health Science Centre in Canada.

Results:

Sixteen patients were identified, with a mean follow up of 30.6 months. Five patients died of recurrence. Complications were common in patients with oropharyngeal cancer. The overall survival and disease-free survival rates at an average of 29.8 months follow up were 50 per cent and 68.8 per cent respectively.

Conclusion:

Salvage surgery using transoral laser microsurgery should be considered in the management of patients with recurrent laryngeal and oropharyngeal cancer. This technique offers acceptable salvage rates with less comorbidity than other treatments.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Phillips, TJ, Sader, C, Brown, T, Bullock, M, Wilke, D, Trites, JR et al. Transoral laser microsurgery versus radiation therapy for early glottic cancer in Canada: cost analysis. J Otolaryngol Head Neck Surg 2009;38:619–23Google ScholarPubMed
2Brandenburg, JH. Laser cordotomy versus radiotherapy: an objective cost analysis. Ann Otol Rhinol Laryngol 2001;110:312–18CrossRefGoogle ScholarPubMed
3Myers, EN, Wagner, RL, Johnson, JT. Microlaryngoscopic surgery for T1 glottic lesions: a cost-effective option. Ann Otol Rhinol Laryngol 1994;103:2830CrossRefGoogle ScholarPubMed
4Gregoire, V, Hamoir, M, Rosier, JF, Counoy, H, Eeckhoudt, L, Neymark, N et al. Cost-minimization analysis of treatment options for T1N0 glottic squamous cell carcinoma: comparison between external radiotherapy, laser microsurgery and partial laryngectomy. Radiother Oncol 1999;53:113CrossRefGoogle ScholarPubMed
5Agrawal, N, Ha, PK. Management of early-stage laryngeal cancer. Otolaryngol Clin North Am 2008;41:757–69, vi–viiCrossRefGoogle ScholarPubMed
6Rigby, MH, Taylor, SM. Review of transoral laser microsurgery for cancer of the upper aerodigestive tract. J Otolaryngol Head Neck Surg 2011;40:113–21Google ScholarPubMed
7Rigby, MH, Taylor, SM. Endoscopic treatment of cis-T2 glottic cancer with a CO(2) laser: preliminary results from a Canadian centre. J Otolaryngol 2007;36:106–10CrossRefGoogle ScholarPubMed
8Taylor, 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
9Ambrosch, P. The role of laser microsurgery in the treatment of laryngeal cancer. Curr Opin Otolaryngol Head Neck Surg 2007;15:82–8CrossRefGoogle ScholarPubMed
10Nibu, K, Kamata, S, Kawabata, K, Nakamizo, M, Nigauri, T, Hoki, K. Partial laryngectomy in the treatment of radiation-failure of early glottic carcinoma. Head Neck 1997;19:116–203.0.CO;2-7>CrossRefGoogle ScholarPubMed
11Shah, JP, Loree, TR, Kowalski, L. Conservation surgery for radiation-failure carcinoma of the glottic larynx. Head Neck 1990;12:326–31CrossRefGoogle ScholarPubMed
12Ganly, I, Patel, SG, Matsuo, J, Singh, B, Kraus, DH, Boyle, JO et al. Results of surgical salvage after failure of definitive radiation therapy for early-stage squamous cell carcinoma of the glottic larynx. Arch Otolaryngol Head Neck Surg 2006;132:5966CrossRefGoogle ScholarPubMed
13Lavey, RS, Calcaterra, TC. Partial laryngectomy for glottic cancer after high-dose radiotherapy. Am J Surg 1991;162:341–4CrossRefGoogle ScholarPubMed
14Paleri, V, Thomas, L, Basavaiah, N, Drinnan, M, Mehanna, H, Jones, T. Oncologic outcomes of open conservation laryngectomy for radiorecurrent laryngeal carcinoma: a systematic review and meta-analysis of English-language literature. Cancer 2011;117:2668–76CrossRefGoogle ScholarPubMed
15Steiner, W, Vogt, P, Ambrosch, P, Kron, M. Transoral carbon dioxide laser microsurgery for recurrent glottic carcinoma after radiotherapy. Head Neck 2004;26:477–84CrossRefGoogle ScholarPubMed
16Roedel, RM, Matthias, C, Wolff, HA, Christiansen, H. Repeated transoral laser microsurgery for early and advanced recurrence of early glottic cancer after primary laser resection. Auris Nasus Larynx 2010;37:340–6CrossRefGoogle ScholarPubMed
17Ansarin, M, Planicka, M, Rotundo, S, Santoro, L, Zurlo, V, Maffini, F et al. Endoscopic carbon dioxide laser surgery for glottic cancer recurrence after radiotherapy: oncological results. Arch Otolaryngol Head Neck Surg 2007;133:1193–7CrossRefGoogle ScholarPubMed
18Ramakrishnan, Y, Drinnan, M, Kwong, FN, Grant, DG, Mehanna, H, Jones, T et al. Oncologic outcomes of transoral laser microsurgery for radiorecurrent laryngeal carcinoma: a systematic review and meta-analysis of English-language literature. Head Neck 2013;2013. Epub 2013 Jun 14Google ScholarPubMed
19Grant, DG, Salassa, JR, Hinni, ML, Pearson, BW, Perry, WC. Carcinoma of the tongue base treated by transoral laser microsurgery, part two: persistent, recurrent and second primary tumors. Laryngoscope 2006;116:2156–61CrossRefGoogle ScholarPubMed
20Levendag, PC, Meeuwis, CA, Visser, AG. Reirradiation of recurrent head and neck cancers: external and/or interstitial radiation therapy. Radiother Oncol 1992;23:615CrossRefGoogle ScholarPubMed
21Barry, B, Baujat, B, Albert, S, Nallet, E, Depondt, J, Guedon, C et al. Total glossectomy without laryngectomy as first-line or salvage therapy. Laryngoscope 2003;113:373–6CrossRefGoogle ScholarPubMed
22Rodriguez, R, Perry, C, Soo, KC, Shaw, HJ. Total glossectomy. Am J Surg 1987;154:415–18CrossRefGoogle ScholarPubMed
23Kasler, M, Fodor, J, Oberna, F, Major, T, Polgar, C, Takacsi-Nagy, Z. Salvage surgery for locoregional failure after definitive radiotherapy for base of tongue cancer. In Vivo 2008;22:803–6Google ScholarPubMed
24Quer, M, Leon, X, Orus, C, Venegas, P, Lopez, M, Burgues, J. Endoscopic laser surgery in the treatment of radiation failure of early laryngeal carcinoma. Head Neck 2000;22:520–33.0.CO;2-K>CrossRefGoogle ScholarPubMed
25Zbaren, P, Nuyens, M, Curschmann, J, Stauffer, E. Histologic characteristics and tumor spread of recurrent glottic carcinoma: analysis on whole-organ sections and comparison with tumor spread of primary glottic carcinomas. Head Neck 2007;29:2632CrossRefGoogle ScholarPubMed
26Roedel, RM, Matthias, C, Wolff, HA, Schindler, P, Aydin, T, Christiansen, H. Transoral laser microsurgery for recurrence after primary radiotherapy of early glottic cancer. Auris Nasus Larynx 2010;37:474–81CrossRefGoogle ScholarPubMed
27Yiotakis, J, Stavroulaki, P, Nikolopoulos, T, Manolopoulos, L, Kandiloros, D, Ferekidis, E et al. Partial laryngectomy after irradiation failure. Otolaryngol Head Neck Surg 2003;128:200–9CrossRefGoogle ScholarPubMed
28Bradley, PJ, Ferlito, A, Suarez, C, Werner, JA, Genden, EM, Shaha, AR et al. Options for salvage after failed initial treatment of anterior vocal commissure squamous carcinoma. Eur Arch Otorhinolaryngol 2006;263:889–94CrossRefGoogle ScholarPubMed