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Transoral laser resection or radiotherapy? Patient choice in the treatment of early laryngeal cancer: a prospective observational cohort study

Published online by Cambridge University Press:  03 April 2017

T Zahoor ,
R Dawson ,
M Sen  and
Z Makura
T Zahoor*
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Leeds General Infirmary, UK
R Dawson
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Leeds General Infirmary, UK
M Sen
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Leeds General Infirmary, UK
Z Makura
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Leeds General Infirmary, UK
*
Address for correspondence: Miss Tosief Zahoor, Department of Otolaryngology/Head and Neck Surgery, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK E-mail: tosiefzahoor@doctors.org.uk
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Abstract

Objectives:

The choices made by patients offered treatment for early laryngeal cancer with radiotherapy or transoral laser resection were reviewed.

Methods:

A prospective review was conducted of all patients diagnosed and treated for early laryngeal carcinoma from December 2002 to September 2009 at the Leeds Teaching Hospitals NHS Trust. A total of 209 patients with tumour stage T1 or T2 laryngeal cancer were treated; each new patient suitable for radiotherapy or transoral laser resection was seen jointly by the clinical (radiation) oncologist and head and neck surgeon, and offered the choice of treatment.

Results:

Of the patients, 47.4 per cent were given a choice between radiotherapy and transoral laser resection; 51.2 per cent were advised to have radiotherapy, and there were no records for the remaining 1.4 per cent. From those given the choice, 59.6 per cent chose transoral laser resection (p < 0.02 (t-test)) and 35.4 per cent chose radiotherapy.

Conclusion:

When given the choice, a statistically significant majority of patients choose transoral laser resection rather than radiotherapy.

Keywords

LasersLaryngeal NeoplasmsOutcomes AssessmentProspective StudiesFrozen SectionsRadiotherapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 6 , June 2017 , pp. 541 - 545
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented (and awarded ‘Best Poster Presentation’) at the British Association of Head and Neck Oncologists (BAHNO) Annual Scientific Meeting, 26 April 2013, London, UK.

References

1 Department of Health. The NHS Cancer Plan: A Plan for Investment, a Plan for Reform. London: Department of Health, 2000 Google Scholar
2 National Institute for Clinical Excellence. Guidance on Cancer Services. Improving Outcomes in Head and Neck Cancers: The Manual. London: National Institute for Clinical Excellence, 2004 Google Scholar
3 Cancer Research UK. Laryngeal cancer statistics. In: http://www.cancerresearchuk.org/cancer-info/cancerstats/types/larynx/ [11 October 2016]Google Scholar
4 Preuss, SF, Cramer, K, Klussmann, JP, Eckel, HE, Guntinas-Lichius, O. Transoral laser surgery for laryngeal cancer: outcome, complications and prognostic factors in 275 patients. Eur J Surg Oncol 2009;35:235–40CrossRefGoogle ScholarPubMed
5 Higgins, KM, Shah, MD, Ogaick, MJ, Enepekides, D. Treatment of early-stage glottic cancer: meta-analysis comparison of laser excision versus radiotherapy. J Otolaryngol Head Neck Surg 2009;38:603–12Google Scholar
6 Ambrosch, P. The role of laser microsurgery in the treatment of laryngeal cancer. Curr Opin Otolaryngol Head Neck Surg 2007;15:82–8CrossRefGoogle ScholarPubMed
7 Feng, Y, Wang, B, Wen, S. Laser surgery versus radiotherapy for T1-T2N0 glottic cancer: a meta-analysis. ORL J Otorhinolaryngol Relat Spec 2011;73:336–42Google Scholar
8 Osborn, HA, Hu, A, Venkatesan, V, Nichols, A, Franklin, JH, Yoo, JH et al. Comparison of endoscopic laser resection versus radiation therapy for the treatment of early glottic carcinoma. J Otolaryngol Head Neck Surg 2011;40:200–4Google Scholar
9 Kujath, M, Kerr, P, Myers, C, Bammeke, F, Lambert, P, Cooke, A et al. Functional outcomes and laryngectomy-free survival after transoral CO2 laser microsurgery for stage 1 and 2 glottic carcinoma. J Otolaryngol Head Neck Surg 2011;40(suppl 1):S49–58Google ScholarPubMed
10 Abdurehim, Y, Hua, Z, Yasin, Y, Xukurhan, A, Imam, I, Yuqin, F. Transoral laser surgery versus radiotherapy: systematic review and meta-analysis for treatment options of T1a glottic cancer. Head Neck 2012;34:23–33 Google Scholar
11 Higgins, KM. What treatment for early-stage glottic carcinoma among adult patients: CO2 endolaryngeal laser excision versus standard fractionated external beam radiation is superior in terms of cost utility? Laryngoscope 2011;121:116–34Google Scholar
12 Silver, CE, Beitler, JJ, Shaha, AR, Rinaldo, A, Ferlito, A. Current trends in initial management of laryngeal cancer: the declining use of open surgery. Eur Arch Otorhinolaryngol 2009;266:1333–52Google Scholar
13 Health and Social Care Information Centre. National Head and Neck Cancer Audit: Key findings for England and Wales for the audit period October 2006 to November 2007. DAHNO third annual report. In: http://content.digital.nhs.uk/catalogue/PUB02647/clin-audi-supp-prog-head-neck-dahn-06-07-rep1.pdf [11 October 2016]Google Scholar
14 Department of Health. Cancer Patient Experience Survey 2011/12: National Report. In: http://www.wp.dh.gov.uk/publications/files/2012/08/Cancer-Patient-Experience-Survey-National-Report-2011-12.pdf [11 October 2016]Google Scholar
15 Cassileth, BR, Soloway, MS, Vogelzang, NJ, Schellhammer, PS, Seidmon, EJ, Hait, HI et al. Patients' choice of treatment in stage D prostate cancer. Urology 1989;33:57–62 CrossRefGoogle ScholarPubMed