title: Transoral CO2 laser microsurgery for Tis-T3 supraglottic squamous cell carcinomas.
abstract: Eighty patients affected by supraglottic cancer were treated by transoral carbon dioxide laser surgery between 1989 and 2006 in two Italian institutions. Patient staging was as follows: 2 pTis, 20 pT1, 38 pT2, and 20 pT3. Simultaneous or 1-month delayed neck dissection (ND) was performed on 27 (34%) patients, unilaterally in 10 and bilaterally in 17. The pN category was as follows: 9 pN0, 6 pN1, 8 pN2b, and 4 pN2c. A total of 16 (20%) patients received complementary radiotherapy (RT) and 5 (6%) were subjected to chemo-RT for persistent tumor after re-excision due to positive margins, multiple lymph nodes, and/or extracapsular spread after ND. The last follow-up was in December 2008. The 5-year overall, disease-specific and disease-free survivals, local control with laser alone, and organ preservation rates calculated by Kaplan-Meier analysis were 84.4, 97.4, 88.3, 96, and 97.2%, respectively. Univariate analysis showed a statistically significant impact on disease-free survival, local control with laser alone, and organ preservation of pT category (p = 0.009, p = 0.01, and p = 0.03, respectively), while pN category and tumor stage negatively influenced disease-free survival (p = 0.007 and p = 0.01, respectively). This series confirms the good overall oncologic outcomes obtained by transoral laser surgery for Tis, T1, T2, and selected T3 supraglottic cancer with minimal pre-epiglottic space involvement.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy. g.peretti@tin.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Peretti
authors.forename: Cesare
authors.initials: C
authors.lastname: Piazza
authors.forename: Mohssen
authors.initials: M
authors.lastname: Ansarin
authors.forename: Luigi
authors.initials: L
authors.lastname: De Benedetto
authors.forename: Daniela
authors.initials: D
authors.lastname: Cocco
authors.forename: Augusto
authors.initials: A
authors.lastname: Cattaneo
authors.forename: Piero
authors.initials: P
authors.lastname: Nicolai
authors.forename: Fausto
authors.initials: F
authors.lastname: Chiesa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D054020:Lasers, Gas; D008207:Lymphatic Metastasis; D008297:Male; D008866:Microsurgery / Q000295:instrumentation; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome