Transoral laser microsurgery of recurrent early glottic cancer after radiation therapy: clinical feasibility and limitations.
OBJECTIVE
Transoral laser microsurgery (TLM) is an accepted alternative to open partial laryngectomy for selected glottic cancers, but its role in salvage of radiation failure is debated.


METHODS
The records of 18 patients treated by TLM for rT1 and rT2 glottic cancer after curative radiation therapy from 2002 to 2007 were retrospectively analyzed.


RESULTS
Of the 18 patients, 10 (56%) remained free of disease after the first TLM. The 5-year local control and laryngeal preservation rates showed better outcomes in rpT1 tumors than in rpT2 tumors (87.5% versus 16.6%, p = 0.02; and 87.5% versus 33.3%, p = 0.03, respectively). However, the 5-year overall survival and disease-specific survival rates showed no significant difference between rpT1 and rpT2 tumors.


CONCLUSIONS
TLM can be a relatively safe and effective salvage option for rT1 glottic cancer. However, because of its high local recurrence rate, TLM may not be generally recommended for rT2 glottic cancer.
Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea.
Young Jin
YJ
Han
Hyoung Shin
HS
Lee
Sung Won
SW
Kim
Jong Chul
JC
Hong
Seung Tae
ST
Kim
Hyo Sang
HS
Park
Kang Dae
KD
Lee
D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005931:Glottis; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008866:Microsurgery / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies