title: The Use of Cryotherapy for Papilloma and Early Laryngeal Cancers: Long-term Results.
abstract: METHODS
  Retrospective chart review.
  
  
  OBJECTIVE
  To determine the efficacy of adjuvant cryotherapy in the treatment of early glottic cancer and laryngeal papillomatosis.
  
  
  BACKGROUND
  The use of cryotherapy in conjunction with traditional modalities has recently been proposed to improve voice outcomes in patients with early laryngeal cancer as compared to pretreatment conditions. This study investigates its utility in improving oncological outcomes and decreasing recurrences of laryngeal papillomatosis.
  
  
  METHODS
  Patients with either early glottic cancer or laryngeal papillomatosis that received cryotherapy as part of their surgical regimen were investigated. All patients were seen at a large tertiary care center within a 10-year window. Demographic data were collected and all postoperative notes were reviewed. Recurrences of the laryngeal cancer were noted, as was the duration of time between successive papillomatosis operations.
  
  
  RESULTS
  The charts of 54 glottic cancer and 29 papillomatosis patients that received cryotherapy were reviewed. One patient from the papillomatosis cohort was excluded from statistical analysis due to lack of follow-up. Overall, 16 (30%) of the laryngeal cancer patient experienced a malignant recurrence. The overall 5-year survival of these patients was 98% and the 5-year disease-free survival was 74%. The use of adjuvant cryotherapy in the treatment of laryngeal papillomatosis extended the duration of time between surgeries by an average of 79 days (P=.23).
  
  
  CONCLUSIONS
  The use of adjuvant cryotherapy in the treatment of early glottic cancer does not improve the rate of carcinoma recurrences. Additionally, cryotherapy does not result in a statistically significant increase in the duration of disease-free period for laryngeal papillomatosis patients, although the observed increase may be clinically important.
authors.affiliation: Cleveland Clinic, Cleveland, OH, USA benninm@ccf.org.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Benninger
authors.affiliation: Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Adeeb
authors.initials: A
authors.lastname: Derakhshan
authors.affiliation: Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Claudio F
authors.initials: CF
authors.lastname: Milstein
mesh_terms: D000328:Adult; D000368:Aged; D017679:Cryotherapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010212:Papilloma / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014833:Voice Quality
keywords: cryotherapy; head and neck; laryngeal cancer; outcomes; papilloma