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Updated: May 10, 2026
Learning Modern Laryngeal Surgery in a Dissection Laboratory
Published on: March 18, 2020
Transoral laser microsurgery for oral squamous cell carcinoma: oncologic outcomes and prognostic factors
Parul Sinha1, Trevor Hackman, Brian Nussenbaum
1Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri.
Background:
Modest survival rates are published for treatment of oral squamous cell carcinoma (OSCC) using conventional approaches. Few cohort studies are available for transoral resection of OSCC.
Methods:
Analysis for recurrence, survival, and prognosis of patients with OSCC treated with transoral laser microsurgery (TLM) ± neck dissection was obtained from a prospective database.
Results:
Ninety-five patients (71 patients had stages T1-T2 and 24 had stages T3-T4 disease) with minimum follow-up of 24 months met criteria and demonstrated negative margins in 95%. Five-year local control (LC) and disease-specific survival (DSS) were 78% and 76%, respectively. Surgical salvage achieved an absolute final locoregional control of 92%. Immune compromise and final margins were prognostic for LC, whereas T classification, N classification, TNM stage, comorbidity, and perineural invasion were also significant for DSS.
Conclusion:
We document a large series of patients with OSCC treated with TLM, incorporating T1 to T4 primaries. A significant proportion of stage III/IV cases demonstrates feasibility of TLM in higher stages, with final margin positivity of 5%, LC greater than 90%, and comparable survival outcomes.