Laser carbon dioxide cordectomy versus open surgery in the treatment of glottic carcinoma: our results.
OBJECTIVE
To analyze oncologic results in patients with glottic cancers treated respectively, by laser CO 2 or open surgery, taking into account specific-disease survival, rate of locoregional recurrences, and their salvageability.


METHODS
Retrospective study of 198 patients treated from January 1993 to June 2002 in the department of otorhinolaryngology at a Catholic university in Rome.


METHODS
Glottic carcinoma were treated by laser CO 2 cordectomy in 132 patients (group 1) and by open surgery in 66 patients (group 2). The statistical analysis was performed by Kaplan Meyer method, log rank test, and chi 2 test.


RESULTS
The log-rank test points out significant differences between the 2 groups regarding specific-disease survival; no differences were found for disease-free survival. Within group 1, 16 patients developed local failure, which was retreated in 6 cases with laser surgery; in 9 (6.8%) with total laryngectomy, only 1 case was inoperable. In this group, 10 patients (62.5%) were salvaged. Within group 2, 18 patients developed local recurrences, which was retreated in 14 (21.21%) cases with total laryngectomy; the other 4 cases were not suitable for surgery. Of these 18, 8 patients (44.5%) were salvaged.


CONCLUSIONS
Our results show significant differences between the 2 groups concerning the specific-disease survival and the salvageability of local recurrences. In fact, in group 1 we found a higher salvage rate and a lower incidence of total laryngectomy. As already suggested, laser therapy leaves the laryngeal cartilaginous framework intact, avoiding the spread of the tumor out of laryngeal organ and resulting in a more favorable oncologic outcome.
Maurizi
Maurizio
M
Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy.
Almadori
Giovanni
G
Plaudetti
Gaetano
G
De Corso
Eugenio
E
Galli
Jacopo
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D007825:Laryngectomy; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D016896:Treatment Outcome
D002245:Carbon Dioxide