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European Archives of Oto-Rhino-Laryngology

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Open Access 01-09-2018 | Laryngology

Evaluation of surgical margin status in patients with early glottic cancer (Tis-T2) treated with transoral CO₂ laser microsurgery, on local control

Authors: Martine Hendriksma, Marc W. Montagne, Ton P. M. Langeveld, Maud Veselic, Peter Paul G. van Benthem, Elisabeth V. Sjögren

Published in: European Archives of Oto-Rhino-Laryngology | Issue 9/2018

Abstract

Purpose

To assess the impact of surgical margins status on local control in patients with primary early glottic (Tis-T2) squamous cell carcinoma after treatment with transoral CO₂ laser microsurgery (TLM) and to assess the significance of additional wound bed biopsies.

Methods

Patients with Tis-T2 tumours treated with TLM type I–III resections according to the European Laryngological Society classification between 2009 and 2013 were included in retrospective analysis. Recurrence rate was determined in patients with free versus non-free specimen margins and wound biopsies. Five-year survival rates were determined using the Kaplan–Meier method. Prognostic impact of pT-category, resection margin status, tumour differentiation, wound bed biopsy status, and number of biopsies on local control (LC) were tested with the log-rank test.

Results

Eighty-four patients were included in the analysis. Positive margins were seen in 68 patients (81.0%). Margin status after TLM did not significantly influence LC (p = 0.489), however, additional wound bed biopsies were significantly associated with lower LC (p = 0.009). Five-year LC, disease-specific survival, overall survival and laryngeal preservation were 78.6, 78.0, 98.6 and 100%, respectively.

Conclusions

Additional wound bed biopsies can help predict local recurrence in patients treated with TLM for early glottic carcinoma. We propose that there is enough evidence to support a wait-and-see policy in patients with positive specimen margins and negative wound bed biopsies. For patients with positive wound bed biopsies, further treatment is warranted.

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Title: Evaluation of surgical margin status in patients with early glottic cancer (Tis-T2) treated with transoral CO2 laser microsurgery, on local control
Authors: Martine Hendriksma
Marc W. Montagne
Ton P. M. Langeveld
Maud Veselic
Peter Paul G. van Benthem
Elisabeth V. Sjögren
Publication date: 01-09-2018
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 9/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-018-5070-9

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Evaluation of surgical margin status in patients with early glottic cancer (Tis-T2) treated with transoral CO₂ laser microsurgery, on local control

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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