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 journalArticle

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

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Microsurgery
Carbon Monoxide
Squamous Cell Carcinoma
Lasers
Disease-Free Survival
Organ Preservation
Neck Dissection
Laser Therapy
Neoplasms
Radiotherapy
Gas Lasers
Kaplan-Meier Estimate
Lymph Nodes

Keywords

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

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Medicine(all)

Cite this

Transoral CO 2 laser microsurgery for Tis-T3 supraglottic squamous cell carcinomas. / Peretti, Giorgio; Piazza, Cesare; Ansarin, Mohssen; De Benedetto, Luigi; Cocco, Daniela; Cattaneo, Augusto; Nicolai, Piero; Chiesa, Fausto.

In: European Archives of Oto-Rhino-Laryngology, Vol. 267, No. 11, 11.2010, p. 1735-1742.

Research output: Contribution to journalArticle

Peretti, G, Piazza, C, Ansarin, M, De Benedetto, L, Cocco, D, Cattaneo, A, Nicolai, P & Chiesa, F 2010, 'Transoral CO 2 laser microsurgery for Tis-T3 supraglottic squamous cell carcinomas', European Archives of Oto-Rhino-Laryngology, vol. 267, no. 11, pp. 1735-1742. https://doi.org/10.1007/s00405-010-1284-1
Peretti, Giorgio ; Piazza, Cesare ; Ansarin, Mohssen ; De Benedetto, Luigi ; Cocco, Daniela ; Cattaneo, Augusto ; Nicolai, Piero ; Chiesa, Fausto. / Transoral CO 2 laser microsurgery for Tis-T3 supraglottic squamous cell carcinomas. In: European Archives of Oto-Rhino-Laryngology. 2010 ; Vol. 267, No. 11. pp. 1735-1742.
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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.",
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AU - Piazza, Cesare

AU - Ansarin, Mohssen

AU - De Benedetto, Luigi

AU - Cocco, Daniela

AU - Cattaneo, Augusto

AU - Nicolai, Piero

AU - Chiesa, Fausto

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N2 - 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.

AB - 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.

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KW - Conservative laryngeal surgery

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KW - Supraglottic cancer

KW - Transoral laser surgery

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