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Function preservation using transoral laser surgery for T2–T3 glottic cancer: oncologic, vocal, and swallowing outcomes

  • Laryngology
  • Published:
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Abstract

Aim of this study was to retrospectively analyze oncologic and functional results of a cohort of T2 and selected T3 glottic tumors treated by transoral laser surgery (TLS). Eighty-nine patients affected by T2 and T3 glottic tumors were treated by TLS from 2005 to 2010 at an academic institution by Type V cordectomies using an “en bloc” or, more frequently, a “piece-meal” technique depending on a number of variables. Kaplan–Meier curves were used to evaluate 5-year overall, disease-specific survivals, local control with laser, and organ preservation rates. Univariate analysis of the impact of different variables was performed. At least 1 year after surgery, we examined: subjective voice evaluation by voice handicap index (VHI), perceptive analysis by GRBAS scale, objective measurements with multidimensional voice program (MDVP), swallowing assessment with the M.D. Anderson Dysphagia Inventory (MDADI), videonasal endoscopic evaluation of swallowing (VEES), and videofluoroscopy (VFS). Fifty-nine patients were pT2 and 30 pT3. The 5-year overall, disease-specific survivals, local control with laser, and organ preservation rates were 92.4, 98.7, 68.5, and 82.1 %, respectively. VHI mean score was 20 (mild dysphonia). Mild and moderate dysphonias were detected by GRBAS in 82 and 18 % of patients, respectively. Mean values of Jitter, Shimmer, and noise-to-harmonic ratio by MDVP resulted 7.87 %, 24.8 %, and 0.37, respectively. Mean value of MDADI was 95.75. Only 2 % of patients at VEES and 4 % at VFS showed tracheal aspiration. Our results highlight that T2 and selected T3 glottic tumors treated by TLS have favorable oncologic and functional outcomes.

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Conflict of interest

The authors declare that this manuscript was conceived and written by the cited authors, they do not have to disclose financial information, and they confirm no conflict of interest concerning this manuscript.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, University of Genoa, Genoa, Italy

    Giorgio Peretti & Renzo Mora

  2. Department of Otorhinolaryngology, Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy

    Cesare Piazza, Francesca Del Bon, Paola Grazioli, Diego Barbieri, Stefano Mangili & Piero Nicolai

Authors
  1. Giorgio Peretti
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  2. Cesare Piazza
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  3. Francesca Del Bon
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  4. Renzo Mora
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  5. Paola Grazioli
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  6. Diego Barbieri
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  7. Stefano Mangili
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Correspondence to Cesare Piazza.

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Presented at the 8th International Conference on Head and Neck Cancer, Toronto, ON, Canada, 21–25 July 2012.

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Peretti, G., Piazza, C., Bon, F.D. et al. Function preservation using transoral laser surgery for T2–T3 glottic cancer: oncologic, vocal, and swallowing outcomes. Eur Arch Otorhinolaryngol 270, 2275–2281 (2013). https://doi.org/10.1007/s00405-013-2461-9

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  • DOI: https://doi.org/10.1007/s00405-013-2461-9

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