title: Transoral laser microsurgery for T1b glottic cancer: review of 51 cases.
abstract: For the treatment of T1b glottic carcinoma, different treatment options, such as transoral laser microsurgery, open surgical techniques, and primary radiotherapy, are under discussion. In this context, the aim of the present study was to describe oncologic results and complication rates of transoral laser microsurgery in treatment of T1b glottic carcinoma. This is a retrospective unicenter chart review of patients treated at an academic tertiary referral center between 1986 and 2006. Fifty-one previously untreated T1b cases were exclusively treated by transoral laser microsurgery and included into this study, 47 were male, and 4 were female. The main outcome measures included local control rate and complications, overall, disease specific, and recurrence-free survival. The median follow-up period was 98 months. The 5-year local control rate was 90.2%; larynx preservation rate was 92.2%. No intra- or postoperative complications, such as wound infections, postoperative bleeding, hematoma, edema, and fistula development, were observed. A single patient required revision surgery due to synechia. Five-year survival rates were: overall 84.7%, disease specific 97.7%, and recurrence free 72.4%. Our data support the conclusion that transoral laser microsurgery is a considerable treatment option in T1b glottic carcinoma. The oncologic outcome was at least comparable to other treatment options, while the perioperative morbidity and complication rate were lower.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Germany. bernhard.weiss@med.uni-goettingen.de.
authors.forename: Bernhard G
authors.initials: BG
authors.lastname: Weiss
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Germany.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Ihler
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Germany.
authors.forename: Yiannis
authors.initials: Y
authors.lastname: Pilavakis
authors.affiliation: University of Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Germany.|Department of Radiation Oncology, Radiologie München, Burgstrasse 7, 80331, Munich, Germany.
authors.forename: Hendrik A
authors.initials: HA
authors.lastname: Wolff
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Canis
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Welz
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Steiner
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D005260:Female; D005858:Germany; D005931:Glottis / Q000473:pathology / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D009055:Mouth / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies
keywords: Carbon dioxide laser; Early glottic squamous cell carcinoma; Larynx; Organ preservation; Transoral laser microsurgery (TLM)