Transoral Laser Microsurgery for Glottic Cancer in Patients Over 75 Years Old

AbstractObjectivesTransoral laser microsurgery is an increasingly common treatment modality for glottic carcinoma. This study aimed to determine the effect of age, gender, stage and time on voice-related quality of life using the Voice Handicap Index-10.MethodsPrimary early glottic carcinoma patients treated with transoral laser microsurgery were included in the study. Self-reported Voice Handicap Index testing was completed pre-operatively, three months post-operatively, and yearly at follow-up appointments.ResultsVoice Handicap Index improvement was found to be dependent on age and tumour stage, while no significant differences were found in Voice Handicap Index for gender. Voice Handicap Index score was significantly improved at 12 months and 24 months. Time versus Voice Handicap Index modelling revealed a preference for non-linear over linear regression.ConclusionAge and stage are important factors, as younger patients with more advanced tumours show greater voice improvement post-operatively. Patient's Voice Handicap Index is predicted to have 95 per cent of maximal improvement by 5.5 months post-operatively.

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Repeated transoral laser microsurgery for early and advanced recurrence of early glottic cancer after primary laser resection

Auris Nasus Larynx ◽

10.1016/j.anl.2009.07.004 ◽

2010 ◽

Vol 37 (3) ◽

pp. 340-346 ◽

Cited By ~ 14

Author(s):

Ralph M.W. Roedel ◽

Christoph Matthias ◽

Hendrik A. Wolff ◽

Hans Christiansen

Keyword(s):

Glottic Cancer ◽

Transoral Laser Microsurgery ◽

Laser Microsurgery ◽

Early Glottic Cancer ◽

Laser Resection

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Voice outcomes following transoral laser microsurgery for early glottic squamous cell carcinoma

The Journal of Laryngology & Otology ◽

10.1017/s0022215107007554 ◽

2007 ◽

Vol 121 (12) ◽

pp. 1184-1188 ◽

Cited By ~ 12

Author(s):

J T Kennedy ◽

P M Paddle ◽

B J Cook ◽

P Chapman ◽

T A Iseli

Keyword(s):

Glottic Cancer ◽

Transoral Laser Microsurgery ◽

Laser Microsurgery ◽

Early Glottic Cancer ◽

Primary Radiotherapy ◽

Second Procedure ◽

European Laryngological Society ◽

Choice Of Therapy ◽

Salvage Laryngectomy

AbstractIntroduction:Early glottic cancer may be treated with primary radiotherapy or transoral laser microsurgery with comparable survival. The choice of therapy therefore depends on patient preference after discussion of risks, benefits and alternatives.Materials and methods:All previously untreated patients undergoing transoral laser microsurgery for T1 or T2 glottic cancer at St Vincent's Hospital between July 1997 and December 2004 had their staging and demographics recorded. Surgery was categorised according to the European Laryngological Society. A voice recording was made pre-operatively then at 12 weeks post-operatively and scored by two independent speech therapists on the Oates Russell Voice Profile – a scale of zero (normal) to five (severe dysphonia). Follow up was for a minimum of two years.Results and analysis:Fifty-three patients with a mean age of 56 were included. The observed survival was T1 89.4 per cent and T2 85.3 per cent after a mean follow up of 47 months. Nineteen patients staged T1 underwent cordectomy. A second procedure was required in 22.2 per cent, however, none required a laryngectomy. Thirty-four patients staged T2 underwent hemilaryngectomy. A second procedure was required in 41.2 per cent including 8.8 per cent requiring salvage laryngectomy. One patient died with unresectable nodal disease. The mean Oates Russell Voice Profile for T1 disease was 2.37 and for T2 2.68 (range 1 to 4) indicating a mild (2) to moderate (3) degree of voice impairment.Conclusions:Survival outcomes following transoral laser microsurgery are comparable to treatment with radiotherapy. Voice impairment is usually mild to moderate following transoral laser microsurgery for early glottic cancer but overall may be greater than in radiotherapy patients. The repeatability of transoral laser microsurgery may result in a lower laryngectomy rate compared with published series using radiotherapy.

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