title: Outcome of transoral laser microsurgery for T2-T3 tumors growing in the laryngeal anterior commissure.
abstract: BACKGROUND
  To evaluate the outcomes of transoral laser microsurgery (TLM) in the treatment of T2 to T3 laryngeal carcinomas growing in the laryngeal anterior commissure.
  
  
  METHODS
  This study was a retrospective analysis of 107 patients. Overall survival, disease-specific survival, and laryngectomy-free survival were analyzed. Technical difficulties, postoperative complications, influence of the learning curve, and the number of surgeries were evaluated.
  
  
  RESULTS
  Five-year overall survival, disease-specific survival, and laryngectomy-free survival were 71%, 79.5%, and 71.4%, respectively. The probability of tumor relapse was related to the status of the margins (p = .01) and to surgical experience (p = .02), but not to tumor exposure (p = .78) or pT category (p = .36). Disease-specific survival differed significantly between the group of patients treated in the early period of surgical experience and those treated in the advanced period of surgical experience (71% vs 94%; p = .02)
  
  
  CONCLUSIONS
  TLM is a useful treatment for T2 to T3 laryngeal carcinomas growing in the laryngeal anterior commissure when it is performed under an advanced learning curve.
authors.affiliation: ENT Surgical Oncology Section, Hospital Clínic, Barcelona, Spain.
authors.forename: José-Luis
authors.initials: JL
authors.lastname: Blanch
authors.forename: Isabel
authors.initials: I
authors.lastname: Vilaseca
authors.forename: Miguel
authors.initials: M
authors.lastname: Caballero
authors.forename: Miguel
authors.initials: M
authors.lastname: Moragas
authors.forename: Joan
authors.initials: J
authors.lastname: Berenguer
authors.forename: Manuel
authors.initials: M
authors.lastname: Bernal-Sprekelsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D002983:Clinical Competence; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy; D053685:Laser Therapy; D054020:Lasers, Gas; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D014833:Voice Quality