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Learning Modern Laryngeal Surgery in a Dissection Laboratory
Published on: March 18, 2020
Management of primary T1-T4 glottic squamous cell carcinoma by transoral laser microsurgery
Andrew T Day1, Parul Sinha2, Brian Nussenbaum2
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
Objectives/Hypothesis:
Evaluate the oncologic outcomes of patients with early and select advanced primary glottic squamous cell carcinoma (SCCa) managed by transoral laser microsurgery (TLM).
Study Design:
Retrospective cohort study.
Methods:
Ninety cases of TLM-managed primary glottic SCCa were identified retrospectively using a prospectively collected database.
Results:
Outcomes of patients with pTis-pT2a disease (n = 65) and pT2b-pT4a disease (n = 25) were, respectively: 5-year local control, 86.2% and 67.5%; 5-year disease-free survival, 64.9% and 44.9%; 5-year disease-specific survival, 96.4% and 59.0%; laryngeal preservation, 96.9% and 80%. Five of nine patients (56%) with supraglottic-glottic-subglottic tumors were local recurrence-free compared to the 70 of 81 (86%) patients with glottic, supraglottic-glottic, and glottic-subglottic tumors. Seven of 13 patients (54%) with positive or indeterminate margins were local recurrence-free compared to 68 of 77 (88%) patients with negative margins.
Conclusions:
Given sample size considerations, this study highlights the satisfactory oncologic outcomes of TLM-treated glottic cancer and the potential importance of margin management and disease extension within the larynx.
Level Of Evidence:
4 Laryngoscope, 127:597-604, 2017.
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