Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-26T05:54:55.186Z Has data issue: false hasContentIssue false
  • English
  • Français

Oncological and functional outcomes after repeat transoral laser microsurgery for the treatment of recurrent early glottic cancer

Published online by Cambridge University Press:  21 February 2020

D Forner ,
M H Rigby ,
M Corsten ,
J R Trites ,
J Pyne  and
S M Taylor
D Forner*
Affiliation:
Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada
M H Rigby
Affiliation:
Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada
M Corsten
Affiliation:
Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada
J R Trites
Affiliation:
Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada
J Pyne
Affiliation:
Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Canada
S M Taylor
Affiliation:
Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Canada
*
Author for correspondence: Dr David Forner, Division of Otolaryngology – Head and Neck Surgery, 5820 University Ave, 3rd Floor Dickson Bldg, Halifax, Nova ScotiaB3H 2Y9, Canada E-mail: david.forner@dal.ca Fax: +1 (902) 473 4384
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Transoral laser microsurgery for glottic squamous cell carcinoma is the standard of care at many institutions. Repeat transoral laser microsurgery for recurrence may avoid the need for radiotherapy and total laryngectomy. This study aimed to identify oncological and functional outcomes in a cohort of patients who had undergone repeat transoral laser microsurgery procedures.

Method

A retrospective review of prospectively collected data of patients treated with transoral laser microsurgery for carcinoma in situ or tumour stages T1 or T2 glottic cancer, from 2003 to 2018.

Results

Twenty patients were identified. Additional treatment was not needed in 45 per cent of patients. The five-year overall survival rate was 90 per cent. The disease-specific survival rate was 100 per cent. The laryngeal preservation rate was 85 per cent. There was improvement in mean Voice Handicap Index-10 scores following repeat transoral laser microsurgery treatment, when comparing the pre- and post-operative periods (mean scores = 15.5 vs 11.5, p = 0.373).

Conclusion

Repeat transoral laser microsurgery can be an oncologically safe alternative to other salvage therapies for glottic squamous cell carcinoma recurrence, without sacrificing functional outcomes.

Keywords

Laryngeal NeoplasmsMicrosurgeryVoice QualityLasersGas
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 2 , February 2020 , pp. 169 - 173
Copyright
Copyright © JLO (1984) Limited, 2020

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.)

Footnotes

Dr D Forner takes responsibility for the integrity of the content of the paper

Presented at the 73rd Canadian Society of Otolaryngology – Head and Neck Surgery Annual Meeting, 1–4 June 2019, Edmonton, Canada.

References

Jones, T, De, M, Foran, B, Harrington, K, Mortimore, S. Laryngeal cancer: United Kingdom National Multidisciplinary guidelines. J Laryngol Otol 2016;130(S2):S75–82CrossRefGoogle ScholarPubMed
Sjögren, EV. Transoral laser microsurgery in early glottic lesions. Curr Otorhinolaryngol Rep 2017;5:56–68CrossRefGoogle ScholarPubMed
Horwich, P, Rigby, MH, MacKay, C, Melong, J, Williams, B, Bullock, M et al. . Laryngeal recurrence sites in patients previously treated with transoral laser microsurgery for squamous cell carcinoma. J Otolaryngol Head Neck Surg 2018;47:14CrossRefGoogle ScholarPubMed
Roedel, 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
Fink, DS, Sibley, H, Kunduk, M, Schexnaildre, M, Kakade, A, Sutton, C et al. Subjective and objective voice outcomes after transoral laser microsurgery for early glottic cancer. Laryngoscope 2016;126:405–7CrossRefGoogle ScholarPubMed
Jacobson, BH, Johnson, A, Grywalski, C, Silbergleit, A, Jacobson, G, Benninger, MS et al. The voice handicap index (VHI): development and validation. Am J Speech Lang Pathol 1997;6:66–70CrossRefGoogle Scholar
Rosen, CA, Lee, AS, Osborne, J, Zullo, T, Murry, T. Development and validation of the voice handicap index-10. Laryngoscope 2004;114:1549–56CrossRefGoogle ScholarPubMed
Canis, M, Martin, A, Ihler, F, Wolff, HA, Kron, M, Matthias, C et al. Transoral laser microsurgery in treatment of pT2 and pT3 glottic laryngeal squamous cell carcinoma–results of 391 patients. Head Neck 2014;36:859–66CrossRefGoogle ScholarPubMed
Day, AT, Sinha, P, Nussenbaum, B, Kallogjeri, D, Haughey, BH. Management of primary T1-T4 glottic squamous cell carcinoma by transoral laser microsurgery. Laryngoscope 2017;127:597–604CrossRefGoogle ScholarPubMed
Warner, L, Lee, K, Homer, J. Transoral laser microsurgery versus radiotherapy for T2 glottic squamous cell carcinoma: a systematic review of local control outcomes. Clin Otolaryngol 2017;42:629–36CrossRefGoogle ScholarPubMed
Batalla, FN, Cueva, MJC, González, BS, Pendás, JLL, Gil, CG, Llames, AL et al. Voice quality after endoscopic laser surgery and radiotherapy for early glottic cancer: objective measurements emphasizing the Voice Handicap Index. Eur Arch Otorhinolaryngol 2008;265:543–8CrossRefGoogle Scholar