S163 – Laser Endoscopic Microsurgery for Supraglottic Cancer

Objectives Report our experience in the endoscopic treatment of supraglottic cancer with CO2 laser. Show the outcome reached with laser microsurgery in the treatment of supraglottic cancer. Methods From 1990 to 2007, 19 patients with supraglottic cancer underwent CO2 laser microsurgery. Results There were 7 (36.8%) T1, 5 (26.4%) T2, and 7 (36.8%) T3. T1 and T2 supraglottic tumors underwent endoscopic surgery with CO2 laser. T2 stage patients also were submitted to unilateral neck dissection. 2 patients (10.5%) with early supraglottic cancers had recurrence (one local and cervical and another cervical metastasis submitted to external surgery). Supraglottectomy with CO2 laser was performed to analize the preepiglottic space and to allow tumor stage. All T3 supraglottic tumors had pre-epiglottic invasion and underwent external supraglottic laryngectomy with neck dissection. Conclusions Endoscopic treatment for laryngeal cancer is an efficient therapy for early supraglottic cancers and is the best method to evaluate the preepiglottic invasion. This therapy makes local function possible without prejudice to oncological results.

Download Full-text

Early supraglottic cancer: how extensive must surgical resection be, if used alone?

The Journal of Laryngology & Otology ◽

10.1017/s0022215106002210 ◽

2006 ◽

Vol 120 (9) ◽

pp. 764-769 ◽

Cited By ~ 3

Author(s):

A A Dünne ◽

R K Davis ◽

C V Dalchow ◽

A M Sesterhenn ◽

J A Werner

Keyword(s):

Neck Dissection ◽

Endoscopic Resection ◽

Squamous Cell Carcinomas ◽

Supraglottic Cancer ◽

Neck Disease ◽

Pathological Evaluation ◽

Oncologic Results ◽

Oncological Results ◽

Regional Failure ◽

Supraglottic Larynx

Objectives: Two centre based evaluations of oncologic results of endoscopic resection of supraglottic cancer without post-operative irradiation.Patients and methods: Twenty-six patients with clinical T1 (n=5) or T2 (n=21) primary squamous cell carcinomas of the supraglottic larynx and with N0 (n=24) or N1 (n=2) neck disease were treated by endoscopic supraglottic laryngectomy coupled with neck dissection(s). Endoscopic resection was standardized whereas neck dissections (NDs) varied from classical modified radical ND to selective ND of levels I to IV.Results: Pathologically, three T2 patients were upstaged to T3, four N0 patients to N1 and one N2 patient down-staged to N1. Within an average of 42 months, there were no local failures and only one regional failure.Conclusions: Endoscopic resection of T1 and T2 supraglottic cancer without post-operative irradiation achieved good oncological results. No patients with lateralized primary cancers were found to have contralateral cancer on pathological evaluation from bilateral dissections.

Download Full-text

T1a Glottic Cancer: Advances in Vocal Outcome Assessment after Transoral CO2-Laser Microsurgery Using the VEM

Journal of Clinical Medicine ◽

10.3390/jcm10061250 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1250

Author(s):

Wen Song ◽

Felix Caffier ◽

Tadeus Nawka ◽

Tatiana Ermakova ◽

Alexios Martin ◽

...

Keyword(s):

Function Analysis ◽

Survival Rates ◽

Severity Index ◽

Glottic Cancer ◽

Vocal Performance ◽

Laser Microsurgery ◽

Kaplan Meier ◽

Objective Parameter ◽

Oncological Results ◽

Perceptual Assessment

Patients with unilateral vocal fold cancer (T1a) have a favorable prognosis. In addition to the oncological results of CO2 transoral laser microsurgery (TOLMS), voice function is among the outcome measures. Previous early glottic cancer studies have reported voice function in patients grouped into combined T stages (Tis, T1, T2) and merged cordectomy types (lesser- vs. larger-extent cordectomies). Some authors have questioned the value of objective vocal parameters. Therefore, the purpose of this exploratory prospective study was to investigate TOLMS-associated oncological and vocal outcomes in 60 T1a patients, applying the ELS protocols for cordectomy classification and voice assessment. Pre- and postoperative voice function analysis included: Vocal Extent Measure (VEM), Dysphonia Severity Index (DSI), auditory-perceptual assessment (GRB), and 9-item Voice Handicap Index (VHI-9i). Altogether, 51 subjects (43 male, eight female, mean age 65 years) completed the study. The 5-year recurrence-free, overall, and disease-specific survival rates (Kaplan–Meier method) were 71.4%, 94.4%, and 100.0%. Voice function was preserved; the objective parameter VEM (64 ± 33 vs. 83 ± 31; mean ± SD) and subjective vocal measures (G: 1.9 ± 0.7 vs. 1.3 ± 0.7; VHI-9i: 18 ± 8 vs. 9 ± 9) even improved significantly (p < 0.001). The VEM best reflected self-perceived voice impairment. It represents a sensitive measure of voice function for quantification of vocal performance.

Download Full-text

Endoscopic CO2 Laser Excisional Biopsy of Early Supraglottic Cancer

The Laryngoscope ◽

10.1288/00005537-199106000-00019 ◽

1991 ◽

Vol 101 (6) ◽

pp. 680???683 ◽

Cited By ~ 5

Author(s):

R. Kim Davis ◽

Steven Michael Kelly ◽

John Hayes

Keyword(s):

Co2 Laser ◽

Excisional Biopsy ◽

Supraglottic Cancer

Download Full-text

Safety Concerns of the CO2 Laser in Traditional and Hand-Held Modes in Transoral Laser Microsurgery

Otolaryngology ◽

10.1177/0194599813496044a207 ◽

2013 ◽

Vol 149 (2_suppl) ◽

pp. P210-P211

Author(s):

Carolyn A. Coughlan ◽

Sunil P. Verma

Keyword(s):

Co2 Laser ◽

Transoral Laser Microsurgery ◽

Laser Microsurgery ◽

Safety Concerns

Download Full-text

A case of cervical metastasis suspected to be from cancer of uterine body detected on neck dissection in a patient with upper gingival cancer

Japanese Journal of Oral & Maxillofacial Surgery ◽

10.5794/jjoms.49.343 ◽

2003 ◽

Vol 49 (5) ◽

pp. 343-346 ◽

Cited By ~ 1

Author(s):

Teru YOSHITAKE ◽

Seiji SUZUKI ◽

Masayuki KAGAYA ◽

Hisao SHIGEMATSU ◽

Kaoru KUSAMA ◽

...

Keyword(s):

Neck Dissection ◽

Cervical Metastasis ◽

Uterine Body

Download Full-text

Transoral CO2 Laser Microsurgery Outcomes for Early Glottic Carcinomas T1-T2

International Archives of Otorhinolaryngology ◽

10.1055/s-0036-1572430 ◽

2016 ◽

Vol 20 (03) ◽

pp. 212-217 ◽

Cited By ~ 7

Author(s):

Frank Reinoso ◽

Alejandra Velasquez ◽

Jose Fernandez ◽

Jose Conde ◽

Carmelo Hidalgo ◽

...

Keyword(s):

Co2 Laser ◽

Laser Microsurgery

Download Full-text

Efficacy of Routine Bilateral Neck Dissection in the Management of Supraglottic Cancer

Otolaryngology ◽

10.1016/j.otohns.2004.04.024 ◽

2004 ◽

Vol 131 (4) ◽

pp. 485-488 ◽

Cited By ~ 31

Author(s):

Robert J. Chiu ◽

Eugene N. Myers ◽

Jonas T. Johnson

Keyword(s):

Neck Dissection ◽

Supraglottic Cancer ◽

Bilateral Neck Dissection

Download Full-text

Transoral CO2 laser management for selected supraglottic tumors and neck dissection

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-011-1603-1 ◽

2011 ◽

Vol 268 (8) ◽

pp. 1181-1186 ◽

Cited By ~ 13

Author(s):

Miklós Csanády ◽

Jenő Czigner ◽

Gábor Vass ◽

József Jóri

Keyword(s):

Neck Dissection ◽

Co2 Laser

Download Full-text

Evaluation of surgical margin status in patients with early glottic cancer (Tis-T2) treated with transoral CO2 laser microsurgery, on local control

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-018-5070-9 ◽

2018 ◽

Vol 275 (9) ◽

pp. 2333-2340 ◽

Cited By ~ 11

Author(s):

Martine Hendriksma ◽

Marc W. Montagne ◽

Ton P. M. Langeveld ◽

Maud Veselic ◽

Peter Paul G. van Benthem ◽

...

Keyword(s):

Co2 Laser ◽

Local Control ◽

Surgical Margin ◽

Margin Status ◽

Glottic Cancer ◽

Laser Microsurgery ◽

Early Glottic Cancer

Download Full-text

Radiation Therapy for Squamous Cell Carcinoma of the Tonsillar Region: A Preferred Alternative to Surgery?

Journal of Clinical Oncology ◽

10.1200/jco.2000.18.11.2219 ◽

2000 ◽

Vol 18 (11) ◽

pp. 2219-2225 ◽

Cited By ~ 94

Author(s):

William M. Mendenhall ◽

Robert J. Amdur ◽

Scott P. Stringer ◽

Douglas B. Villaret ◽

Nicholas J. Cassisi

Keyword(s):

Multivariate Analysis ◽

Neck Dissection ◽

Local Control ◽

Early Stage ◽

Survival Rates ◽

Tumor Stage ◽

Late Complications ◽

Disease Stage ◽

Fractionation Schedule ◽

Cause Specific Survival

PURPOSE: There are no definitive randomized studies that compare radiotherapy (RT) with surgery for tonsillar cancer. The purpose of this study was to evaluate the results of RT alone and RT combined with a planned neck dissection for carcinoma of the tonsillar area and to compare these data with the results of treatment with primary surgery.PATIENTS AND METHODS: Four hundred patients were treated between October 1964 and December 1997 and observed for at least 2 years. One hundred forty-one patients underwent planned neck dissection, and 18 patients received induction (17 patients) or concomitant (one patient) chemotherapy.RESULTS: Five-year local control rates, by tumor stage, were as follows: T1, 83%; T2, 81%; T3, 74%; and T4, 60%. Multivariate analysis revealed that local control was significantly influenced by tumor stage (P = .0001), fractionation schedule (P = .0038), and external beam dose (P = .0227). Local control after RT for early-stage cancers was higher for tonsillar fossa/posterior pillar cancers than for those arising from the anterior tonsillar pillar. Five-year cause-specific survival rates, by disease stage, were as follows: I, 100%; II, 86%; III, 82%; IVa, 63%; and IVb, 22%. Multivariate analysis revealed that cause-specific survival was significantly influenced by overall stage (P = .0001), planned neck dissection (P = .0074), and histologic differentiation (P = .0307). The incidence of severe late complications after treatment was 5%.CONCLUSION: RT alone or combined with a planned neck dissection provides cure rates that are as good as those after surgery and is associated with a lower rate of severe complications.

Download Full-text