Quality of life and voice in patients after laser cordectomy for Tis and T1 glottic carcinomas.
BACKGROUND
Laser cordectomy is gaining popularity for treatment of early glottic carcinoma, but little is known about vocal and quality of life (QOL) outcomes as a function of extent of resection. We prospectively examined QOL and vocal function of patients with carcinoma in situ (Tis) or T1 glottic carcinomas after laser cordectomy.


METHODS
Patients (n = 75) were grouped into those who underwent unilateral subepithelial or subligamental resection (group A, n = 45); those who underwent unilateral transmuscular or total cordectomy (group B, n = 17); and those who underwent extended or bilateral cordectomy including the anterior commissure (group C, n = 19). The European Organization for Research and Treatment of Cancer head and neck cancer specific module (QLQ-H&N35), voice handicap index (VHI), and objective vocal function were examined before and 1 year after cordectomy and compared among the groups.


RESULTS
No major complications were encountered, but local recurrence occurred in 10 patients, with group C showing the highest rate (6/19, 31.6%). Patient-reported speech and social contact scores of QOL questionnaire and VHI scores after surgery were higher in groups B and C than in group A (p < .05). The scores and perceptual and acoustic data were generally improved in all groups after surgery, but were statistically significant only in group A (p < .03).


CONCLUSIONS
Our data suggest that early glottic cancers with a limited extent and infiltration depth have improved outcomes, both oncologically and functionally, compared to those lesions requiring extensive laser resection.
Roh
Jong-Lyel
JL
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. rohjl@amc.seoul.kr
Kim
Dong-Hyun
DH
Kim
Sang Yoon
SY
Park
Chan Il
CI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000601:surgery*; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D016896:Treatment Outcome; D014833:Voice Quality