Two-stage CO2-laser-assisted bilateral cordectomy for cT1b glottic carcinoma.
OBJECTIVE
The aim of the present paper was to investigate the oncological safety of two-stage bilateral cordectomy for the treatment of cT1b glottic SCC, and to compare its oncological outcome and synechia development rate with those of single-stage procedures.


METHODS
A retrospective cohort study was performed at the Otolaryngology Unit of Vittorio Veneto Laryngeal Cancer Center (Italy). The prognostic significance of clinical, pathological and surgical factors was also investigated, in terms of recurrence rate and disease-free survival, in a univariate statistical setting.


RESULTS
Our results indicate that patients treated with primary two-stage bilateral cordectomy achieved local control in 96% of cases, with 95% disease-specific and 88% overall survival rates, and a 95% organ preservation rate, with anterior synechiae developing in 1 case. Involvement of the deep surgical margins correlated with a worse prognosis. Patients developed anterior synechiae less frequently after two-stage bilateral cordectomy, and experienced no higher recurrence rate or shorter disease-free survival than patients treated with a single-stage procedure.


CONCLUSIONS
Two-stage bilateral cordectomy is a safe and effective procedure. In selected patients it could be considered the primary approach for the treatment of early glottic cT1b carcinomas.
Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, via C. Forlanini 71, Treviso, Italy.
Andy
A
Bertolin
Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, via C. Forlanini 71, Treviso, Italy. Electronic address: marcolionello@email.it.
Marco
M
Lionello
Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, via C. Forlanini 71, Treviso, Italy; Otolaryngology Unit, Tempio Pausania Hospital, Tempio Pausania, via G. Deledda 19, Olbia-Tempio, Italy.
Gianni
G
Salis
Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, via C. Forlanini 71, Treviso, Italy.
Giuseppe
G
Rizzotto
Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, via C. Forlanini 71, Treviso, Italy.
Marco
M
Lucioni
D000368:Aged; D005260:Female; D005931:Glottis / Q000473:pathology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D000072662:Margins of Excision; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014833:Voice Quality
Cordectomy; Glottic carcinoma; Transoral laser microsurgery; Two-stage; cT1b