Outcome of transoral laser microsurgery for T2-T3 tumors growing in the laryngeal anterior commissure

Head Neck. 2011 Sep;33(9):1252-9. doi: 10.1002/hed.21605. Epub 2010 Oct 27.

Abstract

Background: To evaluate the outcomes of transoral laser microsurgery (TLM) in the treatment of T2 to T3 laryngeal carcinomas growing in the laryngeal anterior commissure.

Methods: This study was a retrospective analysis of 107 patients. Overall survival, disease-specific survival, and laryngectomy-free survival were analyzed. Technical difficulties, postoperative complications, influence of the learning curve, and the number of surgeries were evaluated.

Results: Five-year overall survival, disease-specific survival, and laryngectomy-free survival were 71%, 79.5%, and 71.4%, respectively. The probability of tumor relapse was related to the status of the margins (p = .01) and to surgical experience (p = .02), but not to tumor exposure (p = .78) or pT category (p = .36). Disease-specific survival differed significantly between the group of patients treated in the early period of surgical experience and those treated in the advanced period of surgical experience (71% vs 94%; p = .02)

Conclusion: TLM is a useful treatment for T2 to T3 laryngeal carcinomas growing in the laryngeal anterior commissure when it is performed under an advanced learning curve.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Clinical Competence
  • Disease-Free Survival
  • Female
  • Humans
  • Laryngeal Neoplasms / mortality*
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy
  • Laser Therapy*
  • Lasers, Gas
  • Male
  • Microsurgery*
  • Middle Aged
  • Neck Dissection
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Voice Quality