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Transoral laser microsurgery in previously irradiated patients with laryngeal cancer
Marianne Abouyared1, Rosemary Ojo1, Christopher Fundakowski1
1Department of Otolaryngology, University of Miami-Leonard M. Miller School of Medicine, Miami, FL, USA.
Purpose:
Early laryngeal cancer is successfully managed with transoral laser microsurgery. Previously radiated patients may experience more post-operative complications. We investigate disease-free survival and secondarily prolonged pain and chondronecrosis.
Materials And Methods:
Retrospective review of 52 patients undergoing transoral laser microsurgery after previous radiation.
Results:
Mean disease-free survival was 36.7 months. Overall disease-free survival was 57.6% at 3-year and 48.4% at 5-year follow-up, with no significant difference between surgery within as opposed to after 60 months of radiation or within as opposed to after 12 months of radiation. Thirteen patients, all with surgery within 60 months of radiation, experienced prolonged pain. Twelve experienced chondronecrosis, all within 12 months of surgery.
Conclusion:
Transoral laser microsurgery for early laryngeal cancer is an adequate therapeutic option in patients with history of radiation with comparable disease-free survival to other reports. Patients undergoing transoral laser microsurgery within 60 months of radiation treatment are more likely to experience prolonged pain.
