title: Transoral laser microsurgery for T1a glottic cancer: review of 404 cases.
abstract: BACKGROUND
  Various therapeutic options exist for treatment of T1a glottic squamous cell cancer (SCC). Radiotherapy (RT) has been favored over surgical excision. This has been challenged by transoral laser microsurgery (TLM) showing low morbidity and good functional results.
  
  
  METHODS
  A retrospective chart review was carried out. Patients with untreated T1a glottic SCC were included in the study. Endpoints were locoregional control, overall survival, disease-specific survival, and absolute rate of larynx preservation.
  
  
  RESULTS
  Four hundred four patients were included in this study. Five-year Kaplan-Meier estimates were: local control 86.8%, overall survival 87.8%, disease-specific survival 98.0%, recurrence-free survival 76.1%, and larynx preservation 97.3%. The complication rate was 1%; the majority of patients had either normal or mildly dysphonic voices.
  
  
  CONCLUSIONS
  Low complication rates, excellent functional outcome, and high rates of organ preservation favor TLM. In agreement with the literature, TLM should be the treatment of choice for patients presenting with T1a glottic SCC.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Göttingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Canis
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Göttingen, Germany.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Ihler
authors.affiliation: Department of Audiology and Phoniatrics, University of Berlin, Berlin, Germany.
authors.forename: Alexios
authors.initials: A
authors.lastname: Martin
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Göttingen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Matthias
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Göttingen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Steiner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015331:Cohort Studies; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005931:Glottis / Q000473:pathology* / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods* / Q000401:mortality; D008297:Male; D008866:Microsurgery / Q000379:methods / Q000401:mortality; D008875:Middle Aged; D009055:Mouth; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods / Q000401:mortality; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: carbon dioxide laser; early glottic squamous cell carcinoma; larynx; organ preservation; transoral laser microsurgery (TLM)