title: The role of primary transoral laser microsurgery in laryngeal cancer: a retrospective study.
abstract: OBJECTIVE
  To investigate the oncologic and survival outcomes of primary transoral laser microsurgery in laryngeal cancer.
  
  
  METHODS
  Retrospective analysis of a database of all patients undergoing primary transoral laser microsurgery with or without adjunctive therapy from June 2000 to October 2013. The median follow-up time was 33 months.
  
  
  METHODS
  A teaching hospital.
  
  
  METHODS
  Two hundred and three patients underwent primary transoral laser microsurgery. Of these, 166 had glottic and 37 had supraglottic squamous cell carcinoma.
  
  
  METHODS
  Overall survival, disease-specific survival, local control and rate of salvage laryngectomy.
  
  
  RESULTS
  Primary transoral laser microsurgery was performed exclusively in 149 (73%) patients, 16 (8%) had transoral laser microsurgery followed by postoperative (chemo)radiotherapy, 6 (3%) had transoral laser microsurgery with neck dissection, and 32 (16%) had transoral laser microsurgery in combination with neck dissection and postoperative (chemo)radiotherapy. In glottic cancer, the 5-year local control was 86%, 86% and 76% in carcinoma in situ (Tis), early-stage (T1, T2) and late-stage (T3, T4) disease, respectively. The 5-year disease-specific survival was 93% in Tis, 96% in early-stage and 65% at late-stage disease. In supraglottic cancer, the 5-year local control was 66% in early-stage and 88% in late-stage disease. The 5-year disease-specific survival was 80% and 75%, respectively. The rate of salvage laryngectomy was 9.9%.
  
  
  CONCLUSIONS
  In carefully selected patients with laryngeal cancer, primary transoral laser microsurgery with or without adjunctive therapy can be organ preserving. It can provide a valid treatment option for patients.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Royal Derby Hospital, Derby, UK.
authors.forename: K
authors.initials: K
authors.lastname: To
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Royal Derby Hospital, Derby, UK.
authors.forename: A
authors.initials: A
authors.lastname: Qureishi
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Royal Derby Hospital, Derby, UK.
authors.forename: S
authors.initials: S
authors.lastname: Mortimore
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Royal Derby Hospital, Derby, UK.
authors.forename: M
authors.initials: M
authors.lastname: De
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D016208:Databases, Factual; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D007825:Laryngectomy; D053685:Laser Therapy / Q000379:methods; D008866:Microsurgery; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016879:Salvage Therapy; D006113:United Kingdom; D055815:Young Adult