Skip to main content
Log in

Transoral laser microsurgery for Tis, T1, and T2 glottic carcinoma: 5-year follow-up

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

The aim of this retrospective study is to evaluate the results obtained with CO2 TOLMS in patients with Tis, T1, and T2 glottic tumors at our Department from 2004 to 2016 treated with CO2 TOLMS. One hundred eighty-five patients having a median age of 67 years (range 42–88) were included in the present analysis. The tumor stages of the patients included 134 pTis-T1a, 12 pT1b, and 39 pT2 cases. Median duration of follow-up for the whole study cohort was 55 months (range 24–108 months). At 5-year follow-up, local control was 91%, 83%, and 79.4% for T1a, T1b, and T2 respectively. Disease-specific survival was 95.5%, 91.6%, and 92.3%. Overall survival was 73.8%, 91.6%, and 82%, and larynx preservation was 96.2%, 83%, and 84.6%. This study confirms that CO2 TOLMS is a safe and standard therapy for selected T1 and T2 glottic carcinoma, and our review on T2 glottic cancer suggests that CO2 TOLMS represents a reliable option in terms of overall survival, disease-specific survival, and laryngeal preservation. However, patients with anterior commissure involvement and T2 cancer should be evaluated with a preoperative MRI in order to exclude the infiltration of the laryngeal framework and to quantify the neoplastic involvement of para-glottic space.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Phillips TJ, Sader C, Brown T, Bullock M, Wilke D, Trites JR, Hart R, Murphy M, Taylor SM (2009) Transoral laser microsurgery versus radiation therapy for early glottic cancer in Canada: cost analysis. J Otolaryngol Head Neck Surg 38(6):619–623

    PubMed  Google Scholar 

  2. Hendriksma M, Heijnen BJ, Sjogren EV (2018) Oncologic and functional outcomes of patients treated with transoral CO2 laser microsurgery or radiotherapy for T2 glottic carcinoma: a systematic review of the literature. Curr Opin Otolaryngol Head Neck Surg 26(2):84–93. https://doi.org/10.1097/MOO.0000000000000438

    Article  PubMed  Google Scholar 

  3. Hendriksma M, van Loon Y, Klop WMC, Hakkesteegt MM, Heijnen BJ, El Hasnaoui I, de Jong M, Langeveld TPM, van Benthem PPG, Baatenburg de Jong RJ, Sjogren EV (2019) Quality of life and voice outcome of patients treated with transoral CO2 laser microsurgery for early glottic carcinoma (T1-T2): a 2-year follow-up study. Eur Arch Otorhinolaryngol 276(3):805–814. https://doi.org/10.1007/s00405-019-05348-1

    Article  PubMed  PubMed Central  Google Scholar 

  4. Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, Meyer L, Gress DM, Byrd DR, Winchester DP (2017) The eighth edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin 67(2):93–99. https://doi.org/10.3322/caac.21388

    Article  PubMed  Google Scholar 

  5. Canis M, Martin A, Ihler F, Wolff HA, Kron M, Matthias C, Steiner W (2014) Transoral laser microsurgery in treatment of pT2 and pT3 glottic laryngeal squamous cell carcinoma - results of 391 patients. Head Neck 36(6):859–866. https://doi.org/10.1002/hed.23389

    Article  PubMed  Google Scholar 

  6. Sjogren EV (2017) Transoral laser microsurgery in early glottic lesions. Curr Otorhinolaryngol Rep 5(1):56–68. https://doi.org/10.1007/s40136-017-0148-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Warner L, Lee K, Homer JJ (2017) Transoral laser microsurgery versus radiotherapy for T2 glottic squamous cell carcinoma: a systematic review of local control outcomes. Clin Otolaryngol 42(3):629–636. https://doi.org/10.1111/coa.12790

    Article  CAS  PubMed  Google Scholar 

  8. Hoffmann C, Cornu N, Hans S, Sadoughi B, Badoual C, Brasnu D (2016) Early glottic cancer involving the anterior commissure treated by transoral laser cordectomy. Laryngoscope 126(8):1817–1822. https://doi.org/10.1002/lary.25757

    Article  PubMed  Google Scholar 

  9. Carta F, Mariani C, Sambiagio GB, Chuchueva N, Lecis E, Gerosa C, Puxeddu R (2018) CO2 Transoral microsurgery for supraglottic squamous cell carcinoma. Front Oncol 8:321. https://doi.org/10.3389/fonc.2018.00321

    Article  PubMed  PubMed Central  Google Scholar 

  10. Rucci L, Gammarota L, Gallo O (1996) Carcinoma of the anterior commissure of the larynx: II. Proposal of a new staging system. Ann Otol Rhinol Laryngol 105(5):391–396. https://doi.org/10.1177/000348949610500512

    Article  CAS  PubMed  Google Scholar 

  11. Gallo A, de Vincentiis M, Manciocco V, Simonelli M, Fiorella ML, Shah JP (2002) CO2 laser cordectomy for early-stage glottic carcinoma: a long-term follow-up of 156 cases. Laryngoscope 112(2):370–374. https://doi.org/10.1097/00005537-200202000-00030

    Article  PubMed  Google Scholar 

  12. Piazza C, Mangili S, Bon FD, Paderno A, Grazioli P, Barbieri D, Perotti P, Garofolo S, Nicolai P, Peretti G (2014) Preoperative clinical predictors of difficult laryngeal exposure for microlaryngoscopy: the Laryngoscore. Laryngoscope 124(11):2561–2567. https://doi.org/10.1002/lary.24803

    Article  PubMed  Google Scholar 

  13. Allegra E, Ferrise P, Trapasso S, Trapuzzano O, Barca A, Tamburrini S, Garozzo A (2014) Early glottic cancer: role of MRI in the preoperative staging. Biomed Res Int 2014:890385. https://doi.org/10.1155/2014/890385

    Article  PubMed  PubMed Central  Google Scholar 

  14. Michel J, Fakhry N, Duflo S, Lagier A, Mancini J, Dessi P, Giovanni A (2011) Prognostic value of the status of resection margins after endoscopic laser cordectomy for T1a glottic carcinoma. Eur Ann Otorhinolaryngol Head Neck Dis 128(6):297–300. https://doi.org/10.1016/j.anorl.2011.05.006

    Article  CAS  PubMed  Google Scholar 

  15. Hendriksma M, Montagne MW, Langeveld TPM, Veselic M, van Benthem PPG, Sjogren EV (2018) Evaluation of surgical margin status in patients with early glottic cancer (Tis-T2) treated with transoral CO2 laser microsurgery, on local control. Eur Arch Otorhinolaryngol 275(9):2333–2340. https://doi.org/10.1007/s00405-018-5070-9

    Article  PubMed  PubMed Central  Google Scholar 

  16. Jumaily M, Faraji F, Osazuwa-Peters N, Walker RJ, Ward GM (2019) Prognostic significance of surgical margins after transoral laser microsurgery for early-stage glottic squamous cell carcinoma. Oral Oncol 97:105–111. https://doi.org/10.1016/j.oraloncology.2019.08.005

    Article  PubMed  Google Scholar 

  17. Galli A, Giordano L, Sarandria D, Di Santo D, Bussi M (2016) Oncological and complication assessment of CO2 laser-assisted endoscopic surgery for T1-T2 glottic tumours: clinical experience. Acta Otorhinolaryngol Ital 36(3):167–173. https://doi.org/10.14639/0392-100X-643

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Hanna J, Brauer PR, Morse E, Mehra S (2019) Margins in laryngeal squamous cell carcinoma treated with transoral laser microsurgery: a national database study. Otolaryngol Head Neck Surg:194599819874315. https://doi.org/10.1177/0194599819874315

  19. Campo F, D'Aguanno V, Greco A, Ralli M, de Vincentiis M (2019) The prognostic value of adding narrow-band imaging in transoral laser microsurgery for early glottic cancer: a review. Lasers Surg Med. https://doi.org/10.1002/lsm.23142

  20. Brondbo K, Fridrich K, Boysen M (2007) Laser surgery of T1a glottic carcinomas; significance of resection margins. Eur Arch Otorhinolaryngol 264(6):627–630. https://doi.org/10.1007/s00405-006-0233-5

    Article  CAS  PubMed  Google Scholar 

  21. Bussu F, Paludetti G, Almadori G, De Virgilio A, Galli J, Micciche F, Tombolini M, Rizzo D, Gallo A, Giglia V, Greco A, Valentini V, De Vincentiis M (2013) Comparison of total laryngectomy with surgical (cricohyoidopexy) and nonsurgical organ-preservation modalities in advanced laryngeal squamous cell carcinomas: a multicenter retrospective analysis. Head Neck 35(4):554–561. https://doi.org/10.1002/hed.22994

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Flaminia Campo.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This retrospective study was carried out in accordance with the ethical requirements of the Helsinki Declarations, the Epidemiological Good Practice Guidelines of the ICH (International Conference of Harmonization), and the existing legislation in Italy.

Informed consent

Informed consent for the study was waived because of the observational retrospective nature of the study. The patients signed a written informed consent before the surgery.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

De Seta, D., Campo, F., D’Aguanno, V. et al. Transoral laser microsurgery for Tis, T1, and T2 glottic carcinoma: 5-year follow-up. Lasers Med Sci 36, 507–512 (2021). https://doi.org/10.1007/s10103-020-03049-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-020-03049-4

Keywords

Navigation