Oncological Outcomes Following Transoral CO₂ Laser Microsurgery for T1 Glottic Cancer

Area of Science:

• Otolaryngology
• Oncology
• Head and Neck Surgery

Background:

• Glottic squamous cell carcinoma (SCC) is a common head and neck cancer.
• Early-stage glottic SCC (Tis, T1) requires effective treatment with organ preservation.
• Transoral laser microsurgery (TLM) is a minimally invasive surgical option.

Purpose of the Study:

• To evaluate the oncological outcomes of transoral laser microsurgery (TLM) for Tis and T1 glottic squamous cell carcinoma.
• To assess local control, overall survival, disease-specific survival, and organ preservation rates after TLM.
• To determine the impact of anterior commissure involvement on treatment outcomes.

Main Methods:

• Retrospective analysis of 53 previously untreated patients with cT1a and cT1b glottic SCC.
• Patients underwent transoral laser microsurgery (TLM).
• Oncological outcomes including local control, survival rates, and organ preservation were analyzed.

Main Results:

• 3-year local control rate was 86.7%, with ultimate local control at 90.5% with laser alone.
• 3-year overall survival and disease-specific survival rates were 92.4% and 98.1%, respectively.
• Organ preservation rate was 98.1%, with no significant impact of anterior commissure involvement on outcomes.

Conclusions:

• Transoral laser microsurgery (TLM) is a safe and effective treatment for early-stage glottic squamous cell carcinoma (Tis, T1).
• TLM offers high rates of local control, survival, and organ preservation with minimal morbidity.
• The procedure is a viable organ-preserving option for selected glottic cancer patients.