Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Indian Journal of Otolaryngology and Head & Neck Surgery
Published in: Indian Journal of Otolaryngology and Head & Neck Surgery 4/2018

01-12-2018 | Original Article

Long Term Oncological Results of Transoral Laser Microsurgery for Early and Moderately Advanced Glottic Carcinoma in Primary and Salvage Settings

Authors: Prem Sagar, Rajeev Kumar, Richa Vaish, Alok Thakar

Published in: Indian Journal of Otolaryngology and Head & Neck Surgery | Issue 4/2018

Login to get access

Abstract

The aim of the study is to document the long term oncological results of trans-oral laser microsurgery (TLM) for early and moderately advanced glottic cancer in primary and salvage settings. In this prospective cohort study 43 consecutive patients of glottic cancer (T1–30, T2–7, and selected T3 with mobile cords-6) were recruited. TLM was performed in these 35 primary and 8 previously treated cases. In our series, the local disease control rate with TLM was 90% (27/30) for T1 disease, 71.4% (5/7) for T2 cancer and 66.6% (4/6) for T3 lesions. The overall disease control rates after subsequent treatment for locoregional recurrences were 100% (30/30), 85.7% (6/7) and 83.3% (5/6) for T1, T2, and T3 glottic cancers respectively. The 5-years disease free survival rate for primary cases was 100% and 50% for salvage cases. The 5-years local disease control rate was 96.4% and 41.67% in primary and salvage TLM settings respectively. The 5-years laryngectomy free rates were 96.3% and 18.75% for primary and salvage cases respectively. TLM offers a minimally invasive and oncologically robust treatment option for early glottic cancer with an overall disease free survival of 100% at 5 years noted for primary untreated cases in this experience. TLM for post radiation salvage cases has however been disappointing and alternate larynx preserving option of open partial laryngectomy needs to be considered in this setting.
Literature
1.
Feng Y, Wang B, Wen S (2011) Laser surgery versus radiotherapy for T1–T2N0 glottic cancer: a meta-analysis. ORL 73(6):336–342CrossRef
2.
Schrijvers ML, van Riel EL, Langendijk JA et al (2009) Higher laryngeal preservation rate after CO2 laser surgery compared with radiotherapy in T1a glottic laryngeal carcinoma. Head Neck 31:759–764CrossRef
3.
Vilaseca I, Bernal-Sprekelson M, Luis Blanch J (2010) Transoral laser microsurgery for T3 laryngeal tumors: prognostic factors. Head Neck 32(7):929–938PubMed
4.
Remacle M, Eckel HE, Antonelli A et al (2000) Endoscopic cordectomy. A proposal for a classification by the Working Committee, European Laryngological Society. Eur Arch Otorhinolaryngol 257:227–231CrossRef
5.
Jako GJ (1972) Laser Surgery of the vocal cords; an experimental study with carbon dioxide lasers on dogs. Laryngoscope 82:2204–2216CrossRef
6.
Strong MS (1975) Laser excision of carcinoma of larynx. Laryngoscope 85(8):1286–1289CrossRef
7.
Ambrosch P (2007) The role of laser microsurgery in the treatment of laryngeal cancer. Curr Opin Otolaryngol Head Neck Surg 15(2):82–88CrossRef
8.
Cabanillas R, Ortega C, Rodrigo JP, Llorente JL, Ortega P, Suarez C (2005) Functional outcomes of transoral laser surgery of supraglottic carcinoma. Acta Otorhinolaryngol Esp 56(4):156–160CrossRef
9.
Rubinstein M, Armstrong WB (2011) Transoral laser microsurgery for laryngeal cancer: a primer and review of laser dosimetry. Lasers Med Sci 26:113–124CrossRef
10.
Dey P, Arnold D, Wight R, Kelly CG, McKenzie K (2002) Raditherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancer. Cochrane Database Sys Rev 2:CD002027
11.
Birchall MA (2008) Early stage glottic cancer: endoscopic excision or radiotherapy—feasibility study. Cancer Research, London
12.
Back G, Sood S (2005) The management of early laryngeal cancer: options for patients and therapists. Curr Opin Otolaryngol Head Neck Surg 13:85–91CrossRef
13.
Higgins KM, Shah MD, Ogaick MJ, Enepekides D (2009) Treatment of early stage glottic cancer: meta-analysis comparison of laser excision versus radiotherapy. J Otolaryngol Head Neck Surg 38:603–612PubMed
14.
Suarez C, Rodrigo JP, Silver CE, Hartl DM et al (2012) Laser surgery for early to moderately advanced glottic, supraglottic and hypopharyngeal cancers. Head Neck 34:1028–1035CrossRef
15.
Sjogren EV, Langeveld TPM, Baatenberg de Jong RJ (2008) Clinical outcomes of T1 glottic carcinoma since the introduction of endoscopic laser surgery as treatment option. Head Neck 30:1167–1174CrossRef
16.
McCoul ED, Har-El G (2009) Meta-analysis of impaired vocal cord mobility as a prognostic factor in T2 glottic carcinoma. Arch Otolaryngol Head Neck Surg 135:479–486CrossRef
17.
Mendenhall WM, Werning JW, Hinerman RW, Amdur RJ, Villaret DB (2004) Management of T1–T2 glottic carcinomas. Cancer 100:1786–1792CrossRef
18.
Bocciolini C, Presutti L, Laudadio P (2005) Oncologic outcome after CO2 laser cordectomy for early-stage glottic carcinoma. Acta Otorhinolaryngol Ital 25:86–93PubMedPubMedCentral
19.
Lester SE, Rigby MH, Taylor SM (2011) Transoral laser microsurgery outcomes with early glottic cancer: the Dalhousie University experience. J Laryngol Otol 125:509–512CrossRef
20.
Peretti G, Piazza C, Cocco D et al (2010) Transoral CO(2) laser treatment for T(is)–T(3) glottic cancer: the University of Brescia experience on 595 patients. Head Neck 32:977–983CrossRef
21.
Blakeslee D, Vaughan CW, Shapshay SM, Simpson GT et al (1984) Excisional biopsy in the selective management of T1 glottic cancer: a three year follow-up study. Laryngoscope 94:488–494CrossRef
22.
Annyas AA, van Overbeek JJM, Escajadillo JR, Hoeksema PE (1984) CO2 laser in malignant lesions of the larynx. Laryngoscope 94:836–838PubMed
23.
Casiano RR, Cooper JD, Lundy DS, Chandler JR (1991) Laser cordectomy for T1 glottic carcinoma: a 10 year experience and videostroboscopic findings. Otolaryngol Head Neck Surg 104:831–837CrossRef
24.
Quer M, Leon X, Orus C, Venegas P, Lopez M, Burgues J (2000) Endoscopic laser surgery in the treatment of early laryngeal carcinoma. Head Neck 8:520–523CrossRef
25.
de Gier HHW, Knegt PPM, de Boer MF, Meeuwis CA, van der Veldon L, Kerrebijn JDF (2001) CO2-laser treatment of recurrent glottic carcinoma. Head Neck 3:177–180CrossRef
26.
Outzen KE, Illum P (1995) CO2-laser therapy for carcinoma of the larynx. J Laryngol Otol 109:111–113CrossRef
27.
Steiner W, Vogt P, Ambrosch P, Kron M (2004) Transoral carbon dioxide laser microsurgery for recurrent glottic carcinoma after radiotherapy. Head Neck 26(6):477–484CrossRef
28.
Roedel RM, Matthias C, Wolff HA, Christiansen H (2010) Repeated transoral laser microsurgery for early and advanced recurrence of early glottic cancer after primary laser resection. Auris Nasus Larynx 37:340–346CrossRef
29.
Peretti G, Piazza C, Bolzoni A et al (2004) Analysis of recurrences in 322 TS, T1, or T2 glottic carcinomas treated by carbon dioxide laser. Ann Otol Rhinol Laryngol. 113:853–858CrossRef
30.
Huang J, Yu Z, Fang J, Chen X et al (2013) Salvage transoral laser microsurgery for early recurrent glottic carcinoma after primary laser treatment. Acta Otolaryngol 133:531–537CrossRef
31.
Makki FM, Rigby MH, Bullock M, Brown T et al (2014) CO2 laser versus cold steel margin analysis following endoscopic excision of glottic cancer. J Otolaryngol Head Neck Surg. 43:6CrossRef
32.
Preuss SF, Cramer K, Klussmann JP, Eckle HE, Lichius G (2009) Transoral laser surgery for laryngeal cancer: outcome, complications and prognostic factors in 275 patients. Eur J Surg Oncol 35(3):235–240CrossRef
33.
Grant DG, Salassa JR, Hinni ML, Pearson BW, Hayden RE, Perry WC (2007) Transoral laser microsurgery for untreated glottic carcinoma. Otolaryngol Head Neck Surg 137(3):482–486CrossRef
34.
Peretti G, Nicolai P, Zinis LOR, Berlucchi M et al (2000) Endoscopic CO2 laser excision for Tis, T1, and T2 glottic carcinomas: cure rate and prognostic factors. Otolaryngol Head Neck Surg 123(1):124–131CrossRef
Metadata
Title
Long Term Oncological Results of Transoral Laser Microsurgery for Early and Moderately Advanced Glottic Carcinoma in Primary and Salvage Settings
Authors
Prem Sagar
Rajeev Kumar
Richa Vaish
Alok Thakar
Publication date
01-12-2018
Publisher
Springer India
Published in
Indian Journal of Otolaryngology and Head & Neck Surgery / Issue 4/2018
Print ISSN: 2231-3796
Electronic ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-018-1505-2

Other articles of this Issue 4/2018

Indian Journal of Otolaryngology and Head & Neck Surgery 4/2018 Go to the issue

Original Article

Ahila’s Diathermy Round Knife for Endoscopic Ear Surgery

Original Article

“Hanger” in Intubation and Laryngoscopy

Original Article

Human Immunodeficiency Virus Infection: Does Highly Active Antiretroviral Therapy Influence Ear Nose Throat Manifestations?

Original Article

Aural Atresia with Cholesteotoma and Its Management Strategies

Original Article

Congenital Cholesteatoma in Adults-Interesting Presentations and Management

Original Article

Aural Polyp is not Always Due to Chronic Otitis Media (COM): Preoperative Computed Tomographic Scan is Good Pointer for Sinister Lesions