title: T1a glottic cancers may be removed by "cold steel" excision biopsies.
abstract: BACKGROUND
  Phonosurgical excision biopsies are gradually replacing traditional punch biopsies during direct lar-yngoscopy. As excision aims at removing all pathologic tissue, some malignant lesions may be completely removed. We present our experience with phonosurgical excision biopsies of T1a glottic cancers without primary radiotherapy.
  
  
  METHODS
  From 2001 till 2010, 24 patients with T1a glottic squamous cell carcinoma did not receive primary radiotherapy as tumours could not be observed at the post-operative control or because of concurrent malignancy or the presence of other co-morbidity. All lesions were excised by instrumental ("cold steel") phonosurgery in which only the epithelial layer above the vocal ligament was removed (type 1 cordectomy). All patients were closely followed by an ear-nose-throat (ENT) surgeon in collaboration with a radiation oncologist.
  
  
  RESULTS
  Relapse was observed in nine of the 24 patients (37.5 %), all within 12 months. The per-operative evaluation of resectability and the results of margin biopsies were insufficient for prediction of recurrence risk. Neither tumour size, primary or secondary excision nor differentiation of the carcinoma influenced the relapse rate.
  
  
  CONCLUSIONS
  T1a glottic cancers may be removed by "cold steel" phonosurgical excision biopsies, but this is inferior to treatment with radiotherapy or laser-assisted phonosurgery. As more than half of the patients did not need radiotherapy, phonosurgery may be considered as sole treatment in selected cases, provided close follow-up with videostroboscopy for the first year after surgery is performed.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Øre-næse-hals-kirurgisk og Audiologisk Klinik, Rigshospitalet, 2100 Copenhagen, Denmark. jacob.melchiors@gmail.com
authors.forename: Jacob
authors.initials: J
authors.lastname: Melchiors
authors.forename: Jesper
authors.initials: J
authors.lastname: Tvedskov
authors.forename: Claus Andrup
authors.initials: CA
authors.lastname: Kristensen
authors.forename: Jens
authors.initials: J
authors.lastname: Bentzen
authors.forename: Niels
authors.initials: N
authors.lastname: Rasmussen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005931:Glottis / Q000473:pathology / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D014833:Voice Quality