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CO2 laser cordectomy for T1–T2 glottic cancer: oncological and functional long-term results

  • Laryngology
  • Published:
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Abstract

The purpose of this study was to assess the validity of CO2 laser cordectomy in the treatment of early glottic cancer and to determine the impact of margin status on disease-free survival and of the operation on voice quality. This is a retrospective review of 169 patients. Quantitative and qualitative variables were statistically compared. The impact on overall and disease-free survivals of different variables was calculated by univariate and multivariate analyses. Ten-year overall and disease free-survivals were 75 % and 60 %, respectively. Age and clinical stage showed a significant negative impact on overall survival, while margin status both on overall and disease-free survivals. The degree of dysphonia was directly related to the extension of the resection. This series confirms the good oncologic and functional outcomes of laser surgery for Tis, T1 and selected T2 glottic tumors. Patients with positive margins should undergo a further treatment or a very close follow-up.

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References

  1. Ferlito A, Carbone A, De Santo LW et al (1996) “Early” cancer of the larynx: the concept as defined by clinician, pathologist, and biologist. Ann Otol Rhinol Laryngol 105:245–250

    Article  CAS  PubMed  Google Scholar 

  2. Mendenhall WM, Werning JW, Hinerman RW et al (2004) Management of T1-T2 Glottic Carcinomas. Cancer 100:1786–1792

    Article  PubMed  Google Scholar 

  3. Goor KM, Peeters J, Mahieu HF et al (2007) Cordectomy by CO2 laser or radiotherapy for small T1a glottic carcinomas: costs, local control, survival, quality of life, and voice quality. Head Neck 29:128–136

    Article  PubMed  Google Scholar 

  4. Crespo AN, Chone CT, Gripp FM, Spina AL, Altemani A (2006) Role of margin status in recurrence after CO2 laser endoscopic resection of early glottic cancer. Acta Otolaryngol 126:306–310

    Article  PubMed  Google Scholar 

  5. Ferri E, Armato E (2008) Diode laser microsurgery for treatment of Tis and T1 glottic carcinomas. Am J Otolaryngol 29:101–105

    Article  PubMed  Google Scholar 

  6. Peretti G, Nicolai P, Redaelli De Zinis LO et al (2000) Endoscopic CO2 laser excision for Tis, T1, and T2 glottic carcinomas: cure rate and prognostic factors. Otolaryngol Head Neck Surg 123:124–131

    Article  CAS  PubMed  Google Scholar 

  7. Gallo A, de Vincetiis M, Manciocco V, Simonelli M, Fiorella ML, Shah JP (2002) CO2 laser cordectomy for early-stage glottic carcinoma: a long-term follow-up of 156 cases. Laryngoscope 112:370–374

    Article  PubMed  Google Scholar 

  8. Bocciolini C, Presutti L, Laudadio P (2005) Oncological outcome after CO2 laser cordectomy for early-stage glottic carcinoma. Acta Otorhinolaryngol Ital 25:86–93

    CAS  PubMed Central  PubMed  Google Scholar 

  9. Peretti G, Piazza C, Bolzoni A (2006) Endoscopic treatment for early glottic cancer: indications and oncologic outcome. Otolaryngol Clin North Am 39:173–189

    Article  PubMed  Google Scholar 

  10. Strong MS, Jako GJ (1972) Laser surgery in the larynx. Ann Otol Rhinol Laryngol 81:791–798

    CAS  PubMed  Google Scholar 

  11. Policarpo M, Aluffi P, Brovelli F, Borello G, Pia F (2004) Oncological and functional results of CO2 laser cordectomy. Acta Otorhinolaryngol Ital 24:267–274

    CAS  PubMed  Google Scholar 

  12. Jackel MC, Ambrosch P, Martin A, Steiner W (2007) Impact of re-resection for inadequate margins on the prognosis of upper aerodigestive tract cancer treated by laser microsurgery. Laryngoscope 117:350–356

    Article  PubMed  Google Scholar 

  13. Remacle M, Eckel HE, Antonelli A et al (2000) Endoscopic cordectomy. A proposal for a classification by the Working Committee, European Laryngological Society. Eur Arch Otorhinolaryngol 257:227–231

    Article  CAS  PubMed  Google Scholar 

  14. Remacle M, Van Haverbeke C, Eckel H et al (2007) Proposal for revision of the European Laryngological Society classification of endoscopic cordectomies. Eur Arch Otorhinolaryngol 264:499–504

    Article  PubMed  Google Scholar 

  15. Edge S, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (2010) American Joint Committee on Cancer (AJCC) cancer staging manual, 7th edn. Springer, Chicago

    Google Scholar 

  16. Schindler O (2009) La voce. Piccin, Padova

    Google Scholar 

  17. Steiner W (1993) Results of curative laser microsurgery of laryngeal carcinomas. Am J Otolaryngol 14:116–121

    Article  CAS  PubMed  Google Scholar 

  18. Pradhan SA, Pal PS, Neeli SI, D’Cruz AK (2003) Transoral laser for early glottic cancers. Arch Otolaryngol Head Neck Surg 129:623–625

    Article  PubMed  Google Scholar 

  19. Eckel HE, Thumfart W, Jungehulsing M, Sittel C, Stennert E (2000) Transoral laser surgery for early glottic carcinoma. Eur Arch Otorhinolaryngol 257:221–226

    Article  CAS  PubMed  Google Scholar 

  20. Sigston E, de Mones E, Babin E et al (2006) Early-stage glottic cancer: oncological results and margins in laser cordectomy. Arch Otolaryngol Head Neck Surg 132:147–152

    Article  PubMed  Google Scholar 

  21. Watanabe A, Tsujie H, Taniguchi M et al (2006) Laryngoscopic detection of pharyngeal carcinoma in situ with narrowband imaging. Laryngoscope 116(4):650–654

    Article  PubMed  Google Scholar 

  22. Piazza C, Dessouky O, Peretti G, Cocco D, De Benedetto L, Nicolai P (2008) Narrow band imaging: a new tool for evaluation of head and neck squamous cell carcinomas. Review of the literature. Acta Otorhinolaryngol Ital 28:49–54

    CAS  PubMed Central  PubMed  Google Scholar 

  23. Ni X-G, He S, Xu Z-G et al (2011) Endoscopic diagnosis of laryngeal cancer and precancerous lesions by Narrow Band Imaging. J Laryngol Otol 125:288–296

    Article  PubMed  Google Scholar 

  24. Bertino G, Cacciola S, Fernandes WB, Fernandes CM, Occhini A, Tinelli C, Benazzo M (2015) Effectiveness of narrow band imaging in the detection of premalignant and malignant lesions of the larynx: validation of a new endoscopic clinical classification. Head Neck 37:215–222

    Article  PubMed  Google Scholar 

  25. Moreau PR (2000) Treatment of laryngeal carcinomas by laser endoscopic microsurgery. Laryngoscope 110(6):1000–1006

    Article  CAS  PubMed  Google Scholar 

  26. Peretti G, Piazza C, Cocco D et al (2010) Transoral CO2 laser treatment for Tis-T3 glottic cancer: the University of Brescia experience on 595 patients. Head Neck 32:977–983

    Article  PubMed  Google Scholar 

  27. Brondbo K, Fridrich K, Boysen M (2007) Laser surgery of T1a glottic carcinomas; significance of resection margins. Eur Arch Otorhinolaryngol 264:627–630

    Article  CAS  PubMed  Google Scholar 

  28. Manola M, Moscillo L, Costa G et al (2008) Conservative laser microsurgery for T1 glottic carcinoma. Auris Nasus Larynx 35:141–147

    Article  CAS  PubMed  Google Scholar 

  29. Ansarin M, Santoro L, Cattaneo A et al (2009) Laser surgery of early glottic cancer; impact of margin status on local control and organ preservation. Arch Otolaryngol Head Neck Surg 135:385–390

    Article  PubMed  Google Scholar 

  30. Motta G, Esposito E, Cassiano B, Motta S (1997) T1-T2-T3 glottic tumors: fifteen years experience with CO2 laser. Acta Otolaryngol Suppl 527:155–159

    Article  CAS  PubMed  Google Scholar 

  31. Spector JG, Sessions DG, Chao KSC, Haughey BH, Hanson JM, Simpson JR et al (1999) Stage I (T1 N0 M0) squamous cell carcinoma of the laryngeal glottis: therapeutic results and voice preservation. Head Neck 21:707–717

    Article  CAS  PubMed  Google Scholar 

  32. Keilmann A, Napiontek U, Engel C, Nakart T, Schneider A, Mann W (2011) Long-term functional outcome after unilateral cordectomy. Orl 73:38–46

    Article  PubMed  Google Scholar 

  33. Peretti G, Piazza C, Balzanelli C, Cantarella G, Nicolai P (2003) Vocal outcome after endoscopic cordectomies for Tis and T1 glottic carcinomas. Ann Otol Rhinol Laryngol 112:174–179

    Article  PubMed  Google Scholar 

  34. Peretti G, Mensi MC, Piazza C et al (2003) Preoperative and postoperative voice in Tis-T1 glottic cancer treated by endoscopic cordectomy: an additional issue for patient counselling. Ann Otol Rhinol Laryngol 112:759–763

    Article  PubMed  Google Scholar 

  35. Ledda GP, Grover N, Pundir V, Masala E, Puxeddu R (2006) Functional outcomes after CO2 laser treatment of early glottic carcinoma. Laryngoscope 116:1007–1011

    Article  PubMed  Google Scholar 

  36. Tomifuji M, Araki K, Niwa K et al (2013) Comparison of voice quality after laser cordectomy with that after radiotherapy or chemoradiotherapy for early glottic carcinoma. Orl 75:18–26

    Article  CAS  PubMed  Google Scholar 

  37. Peretti G, Piazza C, Del Bon F et al (2013) Function preservation using transoral laser surgery for T2-T3 glottic cancer: oncologic, vocal, and swallowing outcomes. Eur Arch Otorhinolaryngol 270:2275–2281

    Article  PubMed  Google Scholar 

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Conflict of interest

The study does not include financial or other relationships which may lead to a conflict of interest or recognizable patient photographs.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Policlinico S. Matteo Foundation, University of Pavia, P.le Golgi 2, 27100, Pavia, Italy

    Giulia Bertino, Giulia Degiorgi, Salvatore Cacciola, Antonio Occhini & Marco Benazzo

  2. Biometric Unit, IRCCS Policlinico S. Matteo Foundation, P.le Golgi 2, 27100, Pavia, Italy

    Carmine Tinelli

Authors
  1. Giulia Bertino
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  2. Giulia Degiorgi
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  3. Carmine Tinelli
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  4. Salvatore Cacciola
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  5. Antonio Occhini
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  6. Marco Benazzo
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Correspondence to Giulia Degiorgi.

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Bertino, G., Degiorgi, G., Tinelli, C. et al. CO2 laser cordectomy for T1–T2 glottic cancer: oncological and functional long-term results. Eur Arch Otorhinolaryngol 272, 2389–2395 (2015). https://doi.org/10.1007/s00405-015-3629-2

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  • DOI: https://doi.org/10.1007/s00405-015-3629-2

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