Advertisement

European Archives of Oto-Rhino-Laryngology

, Volume 267, Issue 11, pp 1735–1742 | Cite as

Transoral CO2 laser microsurgery for Tis-T3 supraglottic squamous cell carcinomas

  • Giorgio PerettiEmail author
  • Cesare Piazza
  • Mohssen Ansarin
  • Luigi De Benedetto
  • Daniela Cocco
  • Augusto Cattaneo
  • Piero Nicolai
  • Fausto Chiesa
Laryngology

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.

Keywords

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

Notes

Conflict of interest statement

The authors have no conflict of interest.

References

  1. 1.
    Greisen O, Carl J, Pedersen M (1997) A consecutive series of patients with laryngeal carcinoma treated by primary irradiation. Acta Oncol 36:279–282CrossRefPubMedGoogle Scholar
  2. 2.
    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 169:584–589PubMedGoogle Scholar
  3. 3.
    Sessions DG, Lenox J, Spector GJ (2005) Supraglottic laryngeal cancer: analysis of treatment results. Laryngoscope 115:1402–1410CrossRefPubMedGoogle Scholar
  4. 4.
    Bocca E, Pignataro O, Oldini C (1983) Supraglottic laryngectomy: 30 years of experience. Ann Otol Rhinol Laryngol 92:14–18PubMedGoogle Scholar
  5. 5.
    Herranz González J, Gavilán J, Martínez Vidal J, Gavilán C (1996) Supraglottic laryngectomy: functional and oncologic results. Ann Otol Rhinol Laryngol 105:18–22PubMedGoogle Scholar
  6. 6.
    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 104:358–363PubMedGoogle Scholar
  7. 7.
    DeSanto LW (1990) Early supraglottic cancer. Ann Otol Rhinol Laryngol 99:593–597PubMedGoogle Scholar
  8. 8.
    Vaughan CW (1978) Transoral laryngeal surgery using the CO2 laser: laboratory experiments and practice. Laryngoscope 88:1399–1420PubMedGoogle Scholar
  9. 9.
    Davis RK, Shapshay MS, Strong MS, Hyams VJ (1983) Transoral partial supraglottic resection using the CO2 laser. Laryngoscope 93:429–432PubMedGoogle Scholar
  10. 10.
    Davis RK, Kelly SM, Hayes J (1991) Supraglottic resection with the CO2 laser. Laryngoscope 101:680–683PubMedGoogle Scholar
  11. 11.
    Zeitels MS, Vaughan CW, Domanowski GF, Fuleihan NS, Simpson GT (1990) Laser epiglottectomy: endoscopic technique and indications. Otolaryngol Head Neck Surg 103:337–343PubMedGoogle Scholar
  12. 12.
    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 115:827–832PubMedGoogle Scholar
  13. 13.
    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 266:993–998CrossRefPubMedGoogle Scholar
  14. 14.
    American Joint Committed on Cancer (2002) AJCC cancer staging manual, 6th edn. Springer, New YorkGoogle Scholar
  15. 15.
    UICC (2002) TNM classification of malignant tumors, 6th edn. Wiley-Liss, New YorkGoogle Scholar
  16. 16.
    Steiner W, Ambrosch P (1996) Stellenwert der Laserchirurgie bei tumoren der oberen Luft- und Speisewege. Onkologie 2:346–351CrossRefGoogle Scholar
  17. 17.
    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 124:1245–1250PubMedGoogle Scholar
  18. 18.
    Zeitels SM, Koufman A, Davis RK, Vaughan CW (1994) Endoscopic treatment of supraglottic and hypopharynx cancer. Laryngoscope 104:71–77CrossRefPubMedGoogle Scholar
  19. 19.
    Ambrosch P, Kron M, Steiner W (1998) Carbon dioxide laser microsurgery for early supraglottic carcinoma. Ann Otol Rhinol Laryngol 107:680–688PubMedGoogle Scholar
  20. 20.
    Eckel HE (1997) Endoscopic laser resection of supraglottic carcinoma. Otolaryngol Head Neck Surg 117:681–687CrossRefPubMedGoogle Scholar
  21. 21.
    Rudert HH, Werner JA, Hoft S (1999) Transoral carbon dioxide laser resection of supraglottic carcinoma. Ann Otol Rhinol Laryngol 108:819–827PubMedGoogle Scholar
  22. 22.
    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 133:1198–1204CrossRefPubMedGoogle Scholar
  23. 23.
    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 136:900–906CrossRefPubMedGoogle Scholar
  24. 24.
    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 25:382–388CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Giorgio Peretti
    • 1
    Email author
  • Cesare Piazza
    • 1
  • Mohssen Ansarin
    • 2
  • Luigi De Benedetto
    • 1
  • Daniela Cocco
    • 1
  • Augusto Cattaneo
    • 2
  • Piero Nicolai
    • 1
  • Fausto Chiesa
    • 2
  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of BresciaBresciaItaly
  2. 2.Department of Head and Neck SurgeryEuropean Institute of OncologyMilanItaly

Personalised recommendations