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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References
Greisen O, Carl J, Pedersen M (1997) A consecutive series of patients with laryngeal carcinoma treated by primary irradiation. Acta Oncol 36:279–282
Inoue T, Inoue T, Ikeda H, Teshima T, Yamazaki H, Murayama S, Othani M, Ozeki S (1993) Comparison of early glottic and supraglottic carcinoma treated with conventional fractionation of radiotherapy. Strahlenther Onkol 169:584–589
Sessions DG, Lenox J, Spector GJ (2005) Supraglottic laryngeal cancer: analysis of treatment results. Laryngoscope 115:1402–1410
Bocca E, Pignataro O, Oldini C (1983) Supraglottic laryngectomy: 30 years of experience. Ann Otol Rhinol Laryngol 92:14–18
Herranz González J, Gavilán J, Martínez Vidal J, Gavilán C (1996) Supraglottic laryngectomy: functional and oncologic results. Ann Otol Rhinol Laryngol 105:18–22
Suárez C, Rodrigo JP, Herranz J, Llorente JL, Martínez JA (1995) Supraglottic laryngectomy with or without postoperative radiotherapy in supraglottic carcinomas. Ann Otol Rhinol Laryngol 104:358–363
DeSanto LW (1990) Early supraglottic cancer. Ann Otol Rhinol Laryngol 99:593–597
Vaughan CW (1978) Transoral laryngeal surgery using the CO2 laser: laboratory experiments and practice. Laryngoscope 88:1399–1420
Davis RK, Shapshay MS, Strong MS, Hyams VJ (1983) Transoral partial supraglottic resection using the CO2 laser. Laryngoscope 93:429–432
Davis RK, Kelly SM, Hayes J (1991) Supraglottic resection with the CO2 laser. Laryngoscope 101:680–683
Zeitels MS, Vaughan CW, Domanowski GF, Fuleihan NS, Simpson GT (1990) Laser epiglottectomy: endoscopic technique and indications. Otolaryngol Head Neck Surg 103:337–343
Peretti G, Piazza C, Cattaneo A, De Benedetto L, Martin E, Nicolai P (2006) Comparison of functional outcomes after endoscopic versus open-neck supraglottic laryngectomies. Ann Otol Rhinol Laryngol 115:827–832
Remacle M, Hantzakos A, Eckel H, Evrard A-S, Bradley PJ, Chevalier D, Djukic V, de Vincentiis M, Friedrich G, Olofsson J, Peretti G, Quer M, Werner J (2009) Endoscopic supraglottic laryngectomy: a proposal for a classification by the working committee on nomenclature, European laryngological society. Eur Arch Otorhinolaryngol 266:993–998
American Joint Committed on Cancer (2002) AJCC cancer staging manual, 6th edn. Springer, New York
UICC (2002) TNM classification of malignant tumors, 6th edn. Wiley-Liss, New York
Steiner W, Ambrosch P (1996) Stellenwert der Laserchirurgie bei tumoren der oberen Luft- und Speisewege. Onkologie 2:346–351
Iro H, Waldfahrer F, Altendorf-Hofmann A, Weidenbecher M, Sauer R, Steiner W (1998) Transoral laser surgery of supraglottic cancer: follow-up of 141 cases. Arch Otolaryngol Head Neck Surg 124:1245–1250
Zeitels SM, Koufman A, Davis RK, Vaughan CW (1994) Endoscopic treatment of supraglottic and hypopharynx cancer. Laryngoscope 104:71–77
Ambrosch P, Kron M, Steiner W (1998) Carbon dioxide laser microsurgery for early supraglottic carcinoma. Ann Otol Rhinol Laryngol 107:680–688
Eckel HE (1997) Endoscopic laser resection of supraglottic carcinoma. Otolaryngol Head Neck Surg 117:681–687
Rudert HH, Werner JA, Hoft S (1999) Transoral carbon dioxide laser resection of supraglottic carcinoma. Ann Otol Rhinol Laryngol 108:819–827
Hinni ML, Salassa JR, Grant DG, Pearson BW, Hayden RE, Martin A, Cristiansen H, Haughey BH, Nussenbaun B, Steiner W (2007) Transoral laser microsurgery for advanced laryngeal cancer. Arch Otolaryngol Head Neck Surg 133:1198–1204
Grant DG, Salassa JR, Hinni ML, Pearson BW, Hayden RE, Perry WC (2007) Transoral laser microsurgery for carcinoma of the supraglottic larynx. Otolaryngol Head Neck Surg 136:900–906
Vilaseca-González I, Bernal-Sprekelsen M, Blanch-Alejandro JL, Moragas-Lluis M (2003) Complications in transoral CO2 laser surgery for carcinoma of the larynx and hypopharynx. Head Neck 25:382–388
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Peretti, G., Piazza, C., Ansarin, M. et al. Transoral CO2 laser microsurgery for Tis-T3 supraglottic squamous cell carcinomas. Eur Arch Otorhinolaryngol 267, 1735–1742 (2010). https://doi.org/10.1007/s00405-010-1284-1
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DOI: https://doi.org/10.1007/s00405-010-1284-1