Transoral CO 2 laser microsurgery for Tis-T3 supraglottic squamous cell carcinomas

Giorgio Peretti, Cesare Piazza, Mohssen Ansarin, Luigi De Benedetto, Daniela Cocco, Augusto Cattaneo, Piero Nicolai, Fausto Chiesa

Research output: Contribution to journalArticlepeer-review

Abstract

Eighty patients affected by supraglottic cancer were treated by transoral carbon dioxide laser surgery between 1989 and 2006 in two Italian institutions. Patient staging was as follows: 2 pTis, 20 pT1, 38 pT2, and 20 pT3. Simultaneous or 1-month delayed neck dissection (ND) was performed on 27 (34%) patients, unilaterally in 10 and bilaterally in 17. The pN category was as follows: 9 pN0, 6 pN1, 8 pN2b, and 4 pN2c. A total of 16 (20%) patients received complementary radiotherapy (RT) and 5 (6%) were subjected to chemo-RT for persistent tumor after re-excision due to positive margins, multiple lymph nodes, and/or extracapsular spread after ND. The last follow-up was in December 2008. The 5-year overall, disease-specific and disease-free survivals, local control with laser alone, and organ preservation rates calculated by Kaplan- Meier analysis were 84.4, 97.4, 88.3, 96, and 97.2%, respectively. Univariate analysis showed a statistically significant impact on disease-free survival, local control with laser alone, and organ preservation of pT category (p = 0.009, p = 0.01, and p = 0.03, respectively), while pN category and tumor stage negatively influenced disease-free survival (p = 0.007 and p = 0.01, respectively). This series confirms the good overall oncologic outcomes obtained by transoral laser surgery for Tis, T1, T2, and selected T3 supraglottic cancer with minimal pre-epiglottic space involvement.

Original languageEnglish
Pages (from-to)1735-1742
Number of pages8
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume267
Issue number11
DOIs
Publication statusPublished - Nov 2010

Keywords

  • Carbon dioxide laser
  • Conservative laryngeal surgery
  • Laryngeal cancer
  • Supraglottic cancer
  • Transoral laser surgery

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Medicine(all)

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