title: Outcomes of transoral laser microsurgical management of T1b stage glottic cancer.
abstract: OBJECTIVE
  This study aimed to evaluate the oncological and voice outcomes of transoral laser microsurgery for tumour stage T1b stage glottic cancer patients.
  
  
  METHODS
  A prospective cohort study in a tertiary care head and neck cancer centre included tumour-node-metastasis stage T1bN0M0 glottic cancer patients scheduled to undergo transoral laser microsurgery from January 2002 until June 2014. Kaplan-Meier five-year analyses of local control, overall survival, disease-specific survival and laryngeal preservation were performed. Voice Handicap Index-10 scores and maximum phonation times were also recorded.
  
  
  RESULTS
  Twenty-one participants with a mean age of 66.8 years were enrolled. The mean follow up was 56.5 months. Kaplan-Meier 5-year survival analysis illustrated a local control rate of 82 per cent, overall survival of 88 per cent, disease-specific survival of 100 per cent, and laryngeal preservation of 100 per cent. The pre-operative Voice Handicap Index-10 score was 19.1 ± 9.47 (mean ± standard deviation (SD)) and the post-operative scores were 13.5 ± 9.29 at three months, 10.44 ± 9.70 at one year and 5.83 ± 4.91 at two years. The pre-operative maximum phonation time was 16.23 ± 5.46 seconds (mean ± SD) and the post-operative values were 14.44 ± 6.73 seconds at three months, 15.27 ± 5.71 seconds at one year and 14.33 ± 6.44 seconds at two years.
  
  
  CONCLUSIONS
  Transoral laser microsurgery yields relatively high rates of oncological control and acceptable voice outcomes, and thus shows utility as a primary treatment modality for T1b glottic cancer.
authors.affiliation: Division of Otolaryngology - Head & Neck Surgery,Dalhousie University,Halifax,Canada.
authors.forename: J A
authors.initials: JA
authors.lastname: Song
authors.affiliation: Division of Otolaryngology - Head & Neck Surgery,Dalhousie University,Halifax,Canada.
authors.forename: M H
authors.initials: MH
authors.lastname: Rigby
authors.affiliation: Division of Otolaryngology - Head & Neck Surgery,Dalhousie University,Halifax,Canada.
authors.forename: J
authors.initials: J
authors.lastname: Trites
authors.affiliation: Division of Otolaryngology - Head & Neck Surgery,Dalhousie University,Halifax,Canada.
authors.forename: R D
authors.initials: RD
authors.lastname: Hart
authors.affiliation: Division of Otolaryngology - Head & Neck Surgery,Dalhousie University,Halifax,Canada.
authors.forename: S M
authors.initials: SM
authors.lastname: Taylor
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005931:Glottis / Q000473:pathology / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009367:Neoplasm Staging; D011446:Prospective Studies; D016896:Treatment Outcome; D014833:Voice Quality
keywords:  Squamous Cell; Carcinoma; Laryngeal Neoplasms; Laser Therapy; Treatment Outcome