title: Transoral laser microsurgery as primary treatment for advanced-stage oropharyngeal cancer: a United States multicenter study.
abstract: BACKGROUND
  Nonsurgical modalities are sometimes advocated as the standard of care for advanced oropharyngeal tumors. Oncologic and functional results have been modest. The aim of our study was to evaluate outcomes of a minimally invasive approach, using transoral laser microsurgery (TLM) as the primary treatment for advanced oropharyngeal carcinoma.
  
  
  METHODS
  A prospectively assembled database of 204 patients with American Joint Committee on Cancer (AJCC) stages III and IV tonsil or tongue base cancer, treated primarily with TLM during 1996-2006 at 3 centers with minimum 2-year follow-up was analyzed. Survival, locoregional control, and swallowing status were recorded.
  
  
  RESULTS
  Mean follow-up was 49 months and 79.4% of patients were alive. Three-year overall survival, disease-specific survival, and disease-free survival were 86%, 88%, and 82%, respectively. Local control was 97%, and 87% of patients had normal swallowing or episodic dysphagia.
  
  
  CONCLUSIONS
  TLM as a primary treatment for advanced oropharyngeal malignancy confers excellent survival and swallowing proficiency.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery Washington University School of Medicine, St. Louis, Missouri, USA. haugheyb@ent.wustl.edu
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Haughey
authors.forename: Michael L
authors.initials: ML
authors.lastname: Hinni
authors.forename: John R
authors.initials: JR
authors.lastname: Salassa
authors.forename: Richard E
authors.initials: RE
authors.lastname: Hayden
authors.forename: David G
authors.initials: DG
authors.lastname: Grant
authors.forename: Jason T
authors.initials: JT
authors.lastname: Rich
authors.forename: Simon
authors.initials: S
authors.lastname: Milov
authors.forename: James S
authors.initials: JS
authors.lastname: Lewis
authors.forename: Murli
authors.initials: M
authors.lastname: Krishna
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059186:Chemoradiotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D037981:Neck Dissection; D018307:Neoplasms, Squamous Cell / Q000401:mortality / Q000601:surgery*; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate