title: Transoral laser microsurgery for oral squamous cell carcinoma: oncologic outcomes and prognostic factors.
abstract: BACKGROUND
  Modest survival rates are published for treatment of oral squamous cell carcinoma (OSCC) using conventional approaches. Few cohort studies are available for transoral resection of OSCC.
  
  
  METHODS
  Analysis for recurrence, survival, and prognosis of patients with OSCC treated with transoral laser microsurgery (TLM) ± neck dissection was obtained from a prospective database.
  
  
  RESULTS
  Ninety-five patients (71 patients had stages T1-T2 and 24 had stages T3-T4 disease) with minimum follow-up of 24 months met criteria and demonstrated negative margins in 95%. Five-year local control (LC) and disease-specific survival (DSS) were 78% and 76%, respectively. Surgical salvage achieved an absolute final locoregional control of 92%. Immune compromise and final margins were prognostic for LC, whereas T classification, N classification, TNM stage, comorbidity, and perineural invasion were also significant for DSS.
  
  
  CONCLUSIONS
  We document a large series of patients with OSCC treated with TLM, incorporating T1 to T4 primaries. A significant proportion of stage III/IV cases demonstrates feasibility of TLM in higher stages, with final margin positivity of 5%, LC greater than 90%, and comparable survival outcomes.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Parul
authors.initials: P
authors.lastname: Sinha
authors.forename: Trevor
authors.initials: T
authors.lastname: Hackman
authors.forename: Brian
authors.initials: B
authors.lastname: Nussenbaum
authors.forename: Ningying
authors.initials: N
authors.lastname: Wu
authors.forename: James S
authors.initials: JS
authors.lastname: Lewis
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Haughey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008197:Lymph Node Excision; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D016879:Salvage Therapy; D000077195:Squamous Cell Carcinoma of Head and Neck; D013524:Surgical Flaps; D016019:Survival Analysis
keywords: laser; oral cancer; survival; tongue; transoral microsurgery