title: Oncological and complication assessment of CO2 laser-assisted endoscopic surgery for T1-T2 glottic tumours: clinical experience.
abstract: Several therapeutic options are used for treatment of early stage glottic carcinoma (Tis/T1/T2): open partial laryngectomy (OPL), radiotherapy and CO2 laser-assisted endoscopic surgery. Laser surgery has gradually gained approval in the management of laryngeal cancer. We present our experience in endoscopic laser surgery for early stage glottic carcinomas. This was a retrospective analysis of 72 patients with T1-T2 glottic cancer treated with laser cordectomy between 2006 and 2012. All patients had at least a 36-month follow-up period. Percentages for disease-specific survival, disease-free survival (DFS) and laryngeal preservation rates were 98.6%, 84.7% and 97.2% respectively. Considering neoplastic features that could predict long-term oncological outcome, tumoural involvement of anterior commissure and pathological staging (pT) significantly correlate with local recurrence (p = 0.021 and p = 0.035) and with a lowered DFS (p = 0.017 and p = 0.023). Other variables such as clinical staging, type of cordectomy, involvement of other structures and surgical margin status showed no significant impact on oncological endpoints. CO2 laser surgery is a reliable technique for T1-T2 glottic cancer considering oncological outcomes. The recurrence rate seems to be affected by involvement of anterior commissure and pT stage.
authors.affiliation: Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Galli
authors.affiliation: Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Giordano
authors.affiliation: Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Sarandria
authors.affiliation: Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Di Santo
authors.affiliation: Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bussi
mesh_terms: D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D053685:Laser Therapy / Q000009:adverse effects*; D054020:Lasers, Gas / Q000009:adverse effects*; D008297:Male; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: CO2 laser-surgery; Early stage; Endoscopic cordectomy; Glottic carcinoma; Laryngeal cancer; Larynx