title: Oncologic and voice outcomes after treatment of early glottic cancer: transoral laser microsurgery versus radiotherapy.
abstract: OBJECTIVE
  To compare the laryngeal preservation rates and voice outcomes after treatment of early glottic cancer between transoral laser microsurgery (TLM) and radiotherapy (RT).
  
  
  METHODS
  Multicenter, retrospective consecutive cohort of stage 1 and 2 glottic carcinoma treated with TLM or RT.
  
  
  METHODS
  Three Canadian academic cancer centres.
  
  
  METHODS
  The patients were those of the regional cancer registries associated with each of the participating universities between 2002 and 2010. The primary oncologic end point was organ preservation. The primary functional outcome measure was the Voice Handicap Index (VHI-10).
  
  
  RESULTS
  A total of 234 patients were treated for early glottic cancer (143 TLM, 91 RT). At 2 years, the laryngeal preservation rate for stage 1 disease was 100% TLM and 92% RT (p < .004); for stage 2 disease, it was 100% TLM and 88% RT (p  =  not significant). There was only one laryngectomy in the TLM group over 5 years posttreatment. There were functional data on 132 patients (83 TLM, 49 RT). Median VHI-10 scores were inferior for laser patients at all three time intervals (6, 12, and 24-48 months posttreament) despite a stage bias in favour of TLM (range of median VHI score over time intervals: TLM  =  9.5-12, RT  =  3.5-8; p  =  .01-.08). However, theses scores represent mild disability in both groups.
  
  
  CONCLUSIONS
  TLM patients have poorer voice quality than RT patients. However, the advantages of TLM in most patients outweigh the degree of voice handicap. Organ preservation rates for TLM were better than or equal to those of RT for both stage 1 and 2 glottic cancer.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery,University of Manitoba, Winnipeg, MB, R3P 1X7. plkerr@me.com
authors.forename: Paul
authors.initials: P
authors.lastname: Kerr
authors.forename: S
authors.initials: S
authors.lastname: Mark Taylor
authors.forename: Matthew
authors.initials: M
authors.lastname: Rigby
authors.forename: Candace
authors.initials: C
authors.lastname: Myers
authors.forename: Heather
authors.initials: H
authors.lastname: Osborn
authors.forename: Pascal
authors.initials: P
authors.lastname: Lambert
authors.forename: Donna
authors.initials: D
authors.lastname: Sutherland
authors.forename: Kevin
authors.initials: K
authors.lastname: Fung
mesh_terms: D000368:Aged; D002170:Canada; D005260:Female; D005931:Glottis / Q000473:pathology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome; D014833:Voice Quality