[Treatment of supraglottic carcinoma with carbon dioxide laser]

To evaluate the feasibility and curative effects of CO2 laser in treatment of supraglottic carcinoma.

The retrospective analysis included 32 case of supraglottic carcinoma from February 1995 to June 2005, TNM classified as follows: T1N0M0: 20 cases, T1N1M0: 2 cases, T2N0M0: 8 cases and T2N1M0: 2 cases. The patients were treated with endoscopic laser surgery and selective neck dissection (12 cases) or functional neck dissection (4 cases). The follow-up period was more than 3 years.

Kaplan-Meier survival analysis shows the overall 5-year survival rate was 90.6%, and the 5-year survival rate of T1 lesions and T2 lesions was 95.6% and 78.2%, respectively. The overall 5-year local control rate was 96. 8%. The 5-year local-regional control rate was 90.3%. With T1 90.9% and T2 89.0% respectively. Two patients had local recurrences, one underwent salvage supraglottic horizontal laryngectomy, another one underwent total laryngectomy. Two cases with regional recurrences underwent radical neck dissection. One of them with concurrent local recurrence was survival after salvage operation. Another one with only regional lesion died of recurrence and pulmonary metastasis after treatment. Four patients experienced minor complications without sequelae. All survival patients had laryngeal preservation except the one who received total laryngectomy.

The results of this study show that endoscopic CO2 laser surgery is highly effective in the treatment of selected supraglottic carcinoma. It shows reliable curative effects and a high larynx preservation rate.