Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2013 Sep;270(10):2719-27.
doi: 10.1007/s00405-013-2382-7. Epub 2013 Feb 14.

Organ preservation in T4a laryngeal cancer: is transoral laser microsurgery an option?

Martin Canis  1 , Friedrich Ihler, Alexios Martin, Hendrik A Wolff, Christoph Matthias, Wolfgang Steiner
Affiliations
Observational Study

Organ preservation in T4a laryngeal cancer: is transoral laser microsurgery an option?

Martin Canis et al. Eur Arch Otorhinolaryngol. 2013 Sep.

Abstract

The main objective of this study is to assess the feasibility of transoral laser microsurgery (TLM) in the treatment of T4a laryngeal cancer and to report the oncological and functional outcomes. This is a retrospective case-series study, held in a single-institute, academic tertiary referral center. Seventy-nine patients with previously untreated T4a glottic (n = 31, 39 %) or supraglottic laryngeal carcinoma (n = 48, 61 %) were included in this study. Five patients (6 %) were treated exclusively by TLM, 16 (20 %) had TLM and unilateral neck dissection, 27 (35 %) had TLM and bilateral neck dissection. Adjuvant (chemo)radiotherapy was additionally administered in 26 (33 %) cases following TLM and neck dissection, and in 5 (6 %) cases after TLM without neck dissection. The main outcome measures included organ preservation, local control, functional outcome, overall, recurrence-free, and disease-specific survival. The median follow-up period was 49 months, 5 year organ preservation rate and local control rate were 80.0 and 67.2 %, 5 year overall, recurrence-free and disease-specific survival were 55.8, 61.9 and 71.8 %. The 5 year overall survival rates were 62.5 % in pN0 cases and 57.2 % in cases with pN-positive neck disease. With respect to survival, these results are comparable to total laryngectomy, while being superior to primary (chemo)radiotherapy. TLM results in a low morbidity, rapid recovery and good function and can be a valid option for organ preserving surgery of pT4a glottic and supraglottic cancer.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Glottic versus supraglottic laryngeal cancer. Local control rate for 79 patients with T4 primary tumor
Fig. 2
Fig. 2
79 patients with T4 laryngeal cancer. a Overall survival rate. b Recurrence-free survival rate. c Disease-specific survival rate
Fig. 3
Fig. 3
pN0 versus pN+. Overall survival rate for 79 patients with T4 laryngeal cancer
Fig. 4
Fig. 4
pN0 versus pN+ for 79 patients with T4 laryngeal cancer. a Recurrence-free survival rate. b Disease-specific survival rate
See this image and copyright information in PMC

References

    1. Hoffman HT, Karnell LH, Funk GF, Robinson RA, Menck HR. The National cancer data base report on cancer of the head and neck. Arch Otolaryngol Head Neck Surg. 1998;124(9):951–962. doi: 10.1001/archotol.124.9.951. - DOI - PubMed
    1. Sikora AG, Toniolo P, DeLacure MD. The changing demographics of head and neck squamous cell carcinoma in the United States. Laryngoscope. 2004;114(11):1915–1923. doi: 10.1097/01.mlg.0000147920.66486.bc. - DOI - PubMed
    1. Strong MS, Jako GJ. Laser surgery in the larynx. Early clinical experience with continuous CO2 laser. Ann Otol Rhinol Laryngol. 1972;81(6):791–798. - PubMed
    1. Steiner W, Ambrosch P, Hess CF, Kron M. Organ preservation by transoral laser microsurgery in piriform sinus carcinoma. Otolaryngol Head Neck Surg. 2001;124(1):58–67. doi: 10.1067/mhn.2001.111597. - DOI - PubMed
    1. Steiner W. Results of curative laser microsurgery of laryngeal carcinomas. Am J Otolaryngol. 1993;14(2):116–121. doi: 10.1016/0196-0709(93)90050-H. - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources