Transoral laser microsurgery for glottic cancer in the elderly: Efficacy and safety

Juan P Rodrigo; Fabian García-Velasco; Petra Ambrosch; Vincent Vander Poorten; Carlos Suárez; Andrés Coca-Pelaz; Primoz Strojan; Kate Hutcheson; Benedikt J Folz; Manuel Bernal-Sprekelsen; Alessandra Rinaldo; Carl E Silver; Alfio Ferlito

doi:10.1002/hed.25616

Transoral laser microsurgery for glottic cancer in the elderly: Efficacy and safety

Head Neck. 2019 Jun;41(6):1816-1823. doi: 10.1002/hed.25616. Epub 2019 Jan 12.

Authors

Affiliations

¹ Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Spain.
² Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts-University of Kiel, Kiel, Germany.
³ Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
⁴ Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium.
⁵ Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
⁶ Department of Head and Neck Surgery, Section of Speech Pathology and Audiology, MD Anderson Cancer Center, Houston, Texas.
⁷ ENT Department, Karl Hansen Clinic, Bad Lippspringe, Germany.
⁸ Department of Otolaryngology, University of Valencia, Valencia, Spain.
⁹ Otorhinolaryngology-Head and neck surgery, University of Udine School of Medicine, Udine, Italy.
¹⁰ Department of Surgery, University of Arizona College of Medicine, Phoenix, Arizona.
¹¹ International Head and Neck Scientific Group, Padua, Italy.

PMID: 30636186
DOI: 10.1002/hed.25616

Abstract

Background: Data about the results of transoral laser microsurgery (TLM) in elderly patients are limited.

Methods: A retrospective study of 72 consecutive cases of glottic carcinoma (63 pT1 and 9 pT2 cases) in elderly patients (≥70 years old, mean 76 years) treated with TLM was made. A systematic review of the literature was performed.

Results: Six patients (8%) had postoperative complications, but no treatment-related deaths were observed. Local recurrences occurred in 12 patients (16.5%): nine with pT1 (14%) and three with pT2 (33%) tumors. Five-year disease-specific survival (DSS), overall survival, and laryngectomy-free survival were 95%, 68%, and 88%, respectively. The literature review indicated that TLM is safe and effective treatment for these patients, with few complications and good local control (>85%) and DSS (>90%) rates.

Conclusions: Our results and the information from the literature show that TLM for glottic cancer in elderly patients can lead to satisfactory treatment results.

Keywords: complications; elderly; laryngeal cancer; transoral laser microsurgery.

Publication types

Systematic Review

MeSH terms

Age Factors
Aged
Carcinoma, Squamous Cell / pathology
Carcinoma, Squamous Cell / surgery
Female
Glottis*
Humans
Laryngeal Neoplasms / pathology
Laryngeal Neoplasms / surgery*
Laryngectomy / adverse effects*
Laser Therapy / adverse effects*
Male
Microsurgery / adverse effects*
Postoperative Complications / epidemiology*
Retrospective Studies
Treatment Outcome