Clinical significance of granulation tissue after transoral laser microsurgery for glottic cancer.
BACKGROUND
Granulation tissue after transoral laser microsurgery can make it difficult to distinguish between normal healing and tumour recurrence.


METHODS
We carried out a retrospective analysis of 316 consecutive glottic carcinomas (Tis-T3). Presence of granulation tissue at one and six months was correlated with demographic and clinical data, tumour and surgical characteristics, and tumour relapse.


RESULTS
Granulation tissue appeared in 53.8 per cent of patients at month 1, resolving spontaneously in 41.8 per cent. Revision surgery was performed in 60.1 per cent and was effective in 41.1 per cent. At month 6, 14.9 per cent of patients presented with granulation tissue. In 74.5 per cent the tissue was surgically removed and was positive for malignancy in 62.9 per cent. Tumour relapse presented in 29.4 per cent with granulation tissue at month 1 and in 61.7 per cent at month 6 (p = 0.000). Granulation tissue at month 1 correlated with thyroid cartilage exposure and continued smoking. At month 6, granulation tissue correlated with thyroid cartilage exposure, the affected surgical margins and diabetes.


CONCLUSIONS
Granulation tissue after transoral laser microsurgery is frequent. When it persists at six months, revision surgery is formally recommended.
Department of Otorhinolaryngology,Althaia Xarxa Assistencial de Manresa,Barcelona,Spain.
E
E
Rioja
ENT Surgical Oncology Section,Hospital Clínic,Barcelona,Spain.
J-L
JL
Blanch
Department of Otorhinolaryngology,Hospital Universitari Josep Trueta,Girona,Spain.
A
A
Borés
Department of Otorhinolaryngology,Hospital Clínic, Barcelona,Spain.
M
M
Bernal-Sprekelsen
Department of Otorhinolaryngology,Hospital Clínic, Barcelona,Spain.
I
I
Vilaseca
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D005260:Female; D005931:Glottis / Q000473:pathology*; D006097:Granulation Tissue / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D053685:Laser Therapy / Q000379:methods; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D055815:Young Adult
carbon dioxide laser