title: Transoral laser surgery of supraglottic cancer: follow-up of 141 patients.
abstract: OBJECTIVE
  To determine the role of transoral laser resection of supraglottic carcinomas.
  
  
  METHODS
  Retrospective unicenter study of the oncologic results of transoral carbon dioxide laser microsurgery for supraglottic carcinomas performed between February 1979 and December 1993. Median follow-up was 37 months.
  
  
  METHODS
  University hospital academic tertiary referral center.
  
  
  METHODS
  We reviewed the medical records of 141 patients (a consecutive sample of 131 men and 10 women; mean age, 60 years) with histologically proven supraglottic carcinomas undergoing transoral laser surgery, possibly in combination with neck dissection or radiotherapy. Stage distribution of patients was as follows: stage I, 23.4%; stage II, 25.5%; stage III, 16.3%; and stage IV, 34.8% (according to the Union Internationale Contre le Cancer staging system).
  
  
  METHODS
  Recurrence-free survival rates and local and regional recurrence rates.
  
  
  RESULTS
  Five-year recurrence-free survival rates were as follows: the whole case load, 65.7%; stage I, 85.0%; stage II, 62.6%; stage III, 74.2%; and stage IV, 45.3%, according to the Union Internationale Contre le Cancer staging system. The local and regional recurrence rates were 16.3% and 9.9%, respectively.
  
  
  CONCLUSIONS
  The oncologic results of transoral carbon dioxide laser surgery are satisfying if clean surgical margins (R0 resection) can be reached. In patients in whom tumor-free margins are not achieved (R1 and R2 resection) and transoral revision is not possible, transcervical procedures (partial or total laryngectomy) should be performed. The indication for transoral supraglottic laryngectomy in T3 lesions should be considered with restraint.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Saarland University, Homburg, Germany. HNOHIRO@MED-RZ.UNI-SB.DE
authors.forename: H
authors.initials: H
authors.lastname: Iro
authors.forename: F
authors.initials: F
authors.lastname: Waldfahrer
authors.forename: A
authors.initials: A
authors.lastname: Altendorf-Hofmann
authors.forename: M
authors.initials: M
authors.lastname: Weidenbecher
authors.forename: R
authors.initials: R
authors.lastname: Sauer
authors.forename: W
authors.initials: W
authors.lastname: Steiner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D019723:Endoscopes; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D020704:Laryngoscopes; D053685:Laser Therapy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant