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European Archives of Oto-Rhino-Laryngology

Erschienen in:

03.05.2019 | Laryngology

Laser transoral microsurgery in treatment of early laryngeal carcinoma

verfasst von: Vojko Djukic, Jovica Milovanović, Ana D. Jotić, Milan Vukasinovic, Miljan M. Folic, Sergey Yrievic Ivanov, Diana Bislanovna Satueva

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 6/2019

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Abstract

Purpose

Laser transoral laryngeal microsurgery has become widely accepted treatment method because of its organ and function preservation and shorter period of hospitalization. The aim of this study was to examine the overall, disease-specific and disease-free survival in patients with early laryngeal carcinoma treated with laser depending on age, gender, common risk factors (tobacco and alcohol use), histopathological tumor grade, anterior commissure involvement, performed tracheotomy, positive surgical margins, T stage, type of endoscopic cordectomy, postoperative radiotherapy and laryngeal preservation.

Methods

Retrospective study included 234 patients with squamocellular carcinoma of the larynx treated with laser transoral laryngeal microsurgery. 5-year overall, disease-specific and disease-free survival and the prognostic impact of mentioned factors were evaluated using Kaplan–Meier and Cox proportional hazard analyses.

Results

5-year OS and DSS was 92.5% and 95.3%, respectively. OS was significantly lower for older patients and in patients with histologically poorly differentiated tumors, 3 and 5 years postoperatively (Log rank test; p = 0.031). DSS was significantly lower in patients with anterior commissure involvement, positive surgical margins and patients who underwent postoperative RT. DFS was significantly lower in patients with anterior commissure involvement, patients with T1b tumor stage and patients who underwent cordectomies type Vb and VI (Log rank, p < 0.05). Laryngeal preservation significantly influenced 5-year OS, DSS and DFS (Log rank, p ≤ 0.001). Multivariate Cox regression analysis showed that age, histological tumor grade and laryngeal preservation were significant negative prognostic factors for 5-year DSS and DFS.

Conclusion

Transoral laryngeal microsurgery delivers excellent oncological results, even in selected patients with higher stages of early laryngeal cancer and anterior commissure involvement.

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Titel: Laser transoral microsurgery in treatment of early laryngeal carcinoma
verfasst von: Vojko Djukic
Jovica Milovanović
Ana D. Jotić
Milan Vukasinovic
Miljan M. Folic
Sergey Yrievic Ivanov
Diana Bislanovna Satueva
Publikationsdatum: 03.05.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 6/2019
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05453-1

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Laser transoral microsurgery in treatment of early laryngeal carcinoma

Abstract

Purpose

Methods

Results

Conclusion

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Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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