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03:36
Development of Compendium for Esophageal Squamous Cell Carcinoma
Published on: April 12, 2024
847
CO2 Transoral Microsurgery for Supraglottic Squamous Cell Carcinoma
Filippo Carta1, Cinzia Mariani1, Giovanni B Sambiagio2
1Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy.
Frontiers in Oncology
|September 21, 2018
Summary
Transoral CO2 laser supraglottic laryngectomy offers a viable oncologic alternative for early-stage supraglottic cancers. Preserving the arytenoid in modified procedures significantly improves swallowing outcomes post-surgery.
Area of Science:
- Otolaryngology
- Head and Neck Surgery
- Oncology
Background:
- Supraglottic carcinoma treatment traditionally involves open surgery or chemoradiotherapy.
- Endoscopic approaches offer potential for improved functional outcomes.
- Transoral CO2 laser surgery provides a minimally invasive option for selected supraglottic cancers.
Purpose of the Study:
- To analyze functional and oncologic outcomes of endoscopic supraglottic laryngectomies.
- To compare different types of endoscopic supraglottic laryngectomies.
- To evaluate the impact of arytenoid preservation on swallowing function.
Main Methods:
- Retrospective clinical study of 42 patients with supraglottic squamous cell carcinoma.
- Transoral CO2 laser approach with classification by European Laryngological Society.
- Evaluation of swallowing using the Swallowing Performance Status Scale.
- Survival analysis using Kaplan-Meier curves.
Main Results:
- High 5-year survival rates (disease-specific 100%, overall 64.6%) for patients without prior radiotherapy/surgery.
- Early oral feeding in less extensive resections (Types I-IIb).
- Significantly better swallowing outcomes with modified Type IVb resections compared to standard Type IVb, especially when arytenoid is preserved.
Conclusions:
- Transoral CO2 laser supraglottic laryngectomy is an oncologically sound alternative.
- Arytenoid preservation in modified Type IVb resections improves functional outcomes and swallowing.
- Endoscopic surgery offers a promising approach for selected supraglottic cancers.
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