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Laser transoral microsurgery in treatment of early laryngeal carcinoma

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Laser transoral laryngeal microsurgery has become widely accepted treatment method because of its organ and function preservation and shorter period of hospitalization. The aim of this study was to examine the overall, disease-specific and disease-free survival in patients with early laryngeal carcinoma treated with laser depending on age, gender, common risk factors (tobacco and alcohol use), histopathological tumor grade, anterior commissure involvement, performed tracheotomy, positive surgical margins, T stage, type of endoscopic cordectomy, postoperative radiotherapy and laryngeal preservation.

Methods

Retrospective study included 234 patients with squamocellular carcinoma of the larynx treated with laser transoral laryngeal microsurgery. 5-year overall, disease-specific and disease-free survival and the prognostic impact of mentioned factors were evaluated using Kaplan–Meier and Cox proportional hazard analyses.

Results

5-year OS and DSS was 92.5% and 95.3%, respectively. OS was significantly lower for older patients and in patients with histologically poorly differentiated tumors, 3 and 5 years postoperatively (Log rank test; p = 0.031). DSS was significantly lower in patients with anterior commissure involvement, positive surgical margins and patients who underwent postoperative RT. DFS was significantly lower in patients with anterior commissure involvement, patients with T1b tumor stage and patients who underwent cordectomies type Vb and VI (Log rank, p < 0.05). Laryngeal preservation significantly influenced 5-year OS, DSS and DFS (Log rank, p ≤ 0.001). Multivariate Cox regression analysis showed that age, histological tumor grade and laryngeal preservation were significant negative prognostic factors for 5-year DSS and DFS.

Conclusion

Transoral laryngeal microsurgery delivers excellent oncological results, even in selected patients with higher stages of early laryngeal cancer and anterior commissure involvement.

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Funding

The research was performed as part of the employment of the authors, working at the Clinic for otorhinolaryngology and maxillofacial surgery, Clinical Center of Serbia, Belgrade, Serbia.

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Authors and Affiliations

  1. Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Pasterova 2, 11000, Belgrade, Serbia

    Vojko Djukic, Jovica Milovanović, Ana D. Jotić, Milan Vukasinovic & Miljan M. Folic

  2. Department of Otorhinolaryngology and Maxillofacial Surgery, Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000, Belgrade, Serbia

    Vojko Djukic, Jovica Milovanović, Ana D. Jotić & Miljan M. Folic

  3. Clinic of Maxillofacial Surgery, Sechenov University, Bolshaya Pirigovskaya St. 19, 119991, Moscow, Russian Federation

    Jovica Milovanović, Sergey Yrievic Ivanov & Diana Bislanovna Satueva

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  1. Vojko Djukic
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  3. Ana D. Jotić
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Correspondence to Ana D. Jotić.

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Djukic, V., Milovanović, J., Jotić, A.D. et al. Laser transoral microsurgery in treatment of early laryngeal carcinoma. Eur Arch Otorhinolaryngol 276, 1747–1755 (2019). https://doi.org/10.1007/s00405-019-05453-1

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  • DOI: https://doi.org/10.1007/s00405-019-05453-1

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