title: Endoscopic CO2 laser surgery for early glottic cancer in patients who are candidates for radiotherapy: results of a prospective nonrandomized study.
abstract: BACKGROUND
  Treatment of early glottic malignancies is controversial, particularly if postoperative endoscopy shows minimal/no residual disease.
  
  
  METHODS
  In a prospective nonrandomized study, we performed endoscopic laser surgery with curative intent in 59 patients with early glottic carcinoma presenting for radiotherapy after diagnosis elsewhere by random biopsy or cordal stripping. We analyzed outcomes and residual cancer in the specimen.
  
  
  RESULTS
  Clinical staging elsewhere did not correspond to (usually underestimated) the pathologic stage in 60.7%. In 22%, no tumor was identified on pathologic examination. After 35.3 months (mean), 93.2% were alive with no evidence of disease. Local control was achieved in 98.3% of the patients, and 13.5% of the patients required radiotherapy. The larynx was conserved in 98.3%.
  
  
  CONCLUSIONS
  Biopsy/stripping are best abandoned for persistent glottic lesions. A single laser endoscopic procedure provides reliable staging and definitive treatment in most cases using fewer resources. Biopsied patients presenting for treatment should be offered laser surgery as an alternative to radiotherapy.
authors.affiliation: Division of Head and Neck Surgery, European Institute of Oncology, Via Ripamonti, 435, 20141 Milano, Italy.
authors.forename: Mohssen
authors.initials: M
authors.lastname: Ansarin
authors.forename: Michal
authors.initials: M
authors.lastname: Zabrodsky
authors.forename: Livia
authors.initials: L
authors.lastname: Bianchi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Renne
authors.forename: Antonella
authors.initials: A
authors.lastname: Tosoni
authors.forename: Luca
authors.initials: L
authors.lastname: Calabrese
authors.forename: Paola
authors.initials: P
authors.lastname: Tredici
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Jereczek-Fossa
authors.forename: Roberto
authors.initials: R
authors.lastname: Orecchia
authors.forename: Fausto
authors.initials: F
authors.lastname: Chiesa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D004724:Endoscopy; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies