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Early outcomes after transoral CO2 laser resection of laryngeal and hypopharyngeal squamous cell carcinoma: one centre's experience

Published online by Cambridge University Press:  03 December 2009

S C Leong ,
C Kathan  and
S Mortimore
S C Leong
Affiliation:
Common Cold Centre, Cardiff University, Wales, UK
C Kathan
Affiliation:
Faculty of Economics, Administrative and Social Sciences, Bilkent University, Ankara, Turkey
S Mortimore*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Derby Hospitals National Health Service Foundation Trust, UK
*
Address for correspondence: Mr S Mortimore, Department of Otolaryngology – Head and Neck Surgery, Derby Royal Infirmary, London Road, Derby DE1 2QY, UK. Fax: 442920876986 E-mail: sean.mortimore@derbyhospitals.nhs.uk
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Abstract

Objectives:

To review early oncological outcomes following transoral CO2 laser resection of laryngeal and hypopharyngeal squamous cell carcinoma.

Design:

Retrospective review of hospital electronic database.

Setting:

Large district general hospital in England, UK.

Main outcome measures:

Patients' three-year disease-specific survival and disease-free survival were evaluated, including post-operative complications, voice quality and swallowing status.

Results:

Seventy-seven patients (16 women and 61 men) were identified. Transoral laser excision of squamous cell carcinoma of the larynx was undergone by 65 patients, and the same procedure in the hypopharynx by 12. Patients with laryngeal cancer had statistically better disease-specific survival than those with hypopharyngeal cancer (p = 0.021), although the cumulative disease-free survival probability was 0.71 for both larynx and hypopharynx groups. Patients who underwent laryngectomy following failed laser treatment or as a salvage procedure had poorer outcomes.

Conclusions:

The overall results of this study were comparable with those of other, larger studies. At three-year follow up, cumulative disease-specific survival probabilities were 0.92 and 0.71 for laryngeal and hypopharyngeal squamous cell carcinoma, respectively.

Keywords

Larynx NeoplasmsPharynx NeoplasmsLaser Therapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 2 , February 2010 , pp. 185 - 193
Copyright
Copyright © JLO (1984) Limited 2009

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References

1Ambrosch, P. The role of laser microsurgery in the treatment of laryngeal cancer. Curr Opin Otolaryngol Head Neck Surg 2007;15:82–8CrossRefGoogle ScholarPubMed
2Cabanillas, R, Rodrigo, JP, Llorente, JL, Suárez, C. Oncologic outcomes of transoral laser surgery of supraglottic carcinoma compared with a transcervical approach. Head Neck 2008;30:750–5CrossRefGoogle ScholarPubMed
3Steiner, W. Results of curative laser microsurgery of laryngeal carcinomas. Am J Otolaryngol 1993;14:116–21CrossRefGoogle ScholarPubMed
4Iro, H, Waldfahrer, F, Altendorf-Hofmann, A, Weidenbecher, M, Sauer, R, Steiner, W. Transoral laser surgery of supraglottic cancer: follow-up of 141 patients. Arch Otolaryngol Head Neck Surg 1998;124:1245–50CrossRefGoogle ScholarPubMed
5Grant, DG, Salassa, JR, Hinni, ML, Pearson, BW, Hayden, RE, Perry, WC. Transoral laser microsurgery for recurrent laryngeal and pharyngeal cancer. Otolaryngol Head Neck Surg 2008;138:606–13CrossRefGoogle ScholarPubMed
6Martin, A, Jäckel, MC, Christiansen, H, Mahmoodzada, M, Kron, M, Steiner, W. Organ preserving transoral laser microsurgery for cancer of the hypopharynx. Laryngoscope 2008;118:398–402CrossRefGoogle ScholarPubMed
7Dey, P, Arnold, D, Wight, R, MacKenzie, K, Kelly, C, Wilson, J. Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancer. Cochrane Database Syst Rev 2002;(2):CD002027CrossRefGoogle ScholarPubMed
8Maurizi, M, Almadori, G, Plaudetti, G, De Corso, E, Galli, J. Laser carbon dioxide cordectomy versus open surgery in the treatment of glottic carcinoma: our results. Otolaryngol Head Neck Surg 2005;132:857–61CrossRefGoogle ScholarPubMed
9Hinni, ML, Salassa, JR, Grant, DG, Pearson, BW, Hayden, RE, Martin, A et al. Transoral laser microsurgery for advanced laryngeal cancer. Arch Otolaryngol Head Neck Surg 2007;133:1198–204CrossRefGoogle ScholarPubMed
10Vilaseca, I, Blanch, JL, Bernal-Sprekelsen, M, Moragas, M. CO2 laser surgery: a larynx preservation alternative for selected hypopharyngeal carcinomas. Head Neck 2004;26:953–9CrossRefGoogle ScholarPubMed
11Eckel, HE, Staar, S, Volling, P, Sittel, C, Damm, M, Jungehuelsing, M. Surgical treatment for hypopharynx carcinoma: feasibility, mortality, and results. Otolaryngol Head Neck Surg 2001;124:561–9CrossRefGoogle ScholarPubMed
12Vilaseca-González, I, Bernal-Sprekelsen, M, Blanch-Alejandro, JL, Moragas-Lluis, M. Complications in transoral CO2 laser surgery for carcinoma of the larynx and hypopharynx. Head Neck 2003;25:382–8CrossRefGoogle ScholarPubMed
13Yilmaz, T, Turan, E, Gürsel, B, Onerci, M, Kaya, S. Positive surgical margins in cancer of the larynx. Eur Arch Otorhinolaryngol 2001;258:188–91Google ScholarPubMed
14Black, C, Marotti, J, Zarovnaya, E, Paydarfar, J. Critical evaluation of frozen section margins in head and neck cancer resections. Cancer 2006;107:2792–800CrossRefGoogle ScholarPubMed
15Cooley, ML, Hoffman, HT, Robinson, RA. Discrepancies in frozen section mucosal margin tissue in laryngeal squamous cell carcinoma. Head Neck 2002;24:262–7CrossRefGoogle ScholarPubMed
16Remacle, M, Hamoir, M, Marbaix, E, Deggouj, N, Frederickx, Y. Interest in frozen section examination of margins and lymph nodes in laryngeal surgery. J Laryngol Otol 1988;102:818–21CrossRefGoogle ScholarPubMed
17Gandour-Edwards, RF, Donald, PJ, Wiese, DA. Accuracy of intraoperative frozen section diagnosis in head and neck surgery: experience at a university medical center. Head Neck 1993;15:33–8CrossRefGoogle Scholar
18Jäckel, MC, Ambrosch, P, Martin, A, Steiner, W. Impact of re-resection for inadequate margins on the prognosis of upper aerodigestive tract cancer treated by laser microsurgery. Laryngoscope 2007;117:350–6CrossRefGoogle ScholarPubMed
19Kim, JW, Yoon, SY, Park, IS, Park, SW, Kim, YM. Correlation between radiological images and pathological results in supraglottic cancer. J Laryngol Otol 2008;122:1224–9CrossRefGoogle ScholarPubMed
20McWhorter, AJ, Hoffman, HT. Transoral laser microsurgery for laryngeal malignancies. Curr Probl Cancer 2005;29:180–9CrossRefGoogle ScholarPubMed
21Steiner, W, Ambrosch, P. Endoscopic Laser Surgery of the Upper Aerodigestive Tract: with Special Emphasis on Cancer Surgery. Stuttgart: Thieme Medical Publishers, 2000;39–42Google Scholar
22National Institute for Clinical Excellence. Improving Outcomes in Head and Neck Cancers – the Manual. London: National Institute for Clinical Excellence, 2004Google Scholar
23Becker, M. Neoplastic invasion of laryngeal cartilage: radiologic diagnosis and therapeutic implications. Eur J Radiol 2000;33:216–29CrossRefGoogle ScholarPubMed
24Castelijns, JA, Becker, M, Hermans, R. Impact of cartilage invasion on treatment and prognosis of laryngeal cancer. Eur Radiol 1996;6:156–69CrossRefGoogle ScholarPubMed