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Learning Modern Laryngeal Surgery in a Dissection Laboratory
Published on: March 18, 2020
Treatment of Early Glottic cancer with Transoral Laser Microsurgery: An Australian Experience
Navid Ahmadi1,2,3, Danielle Stone4, Murray Stokan5
1Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, NSW Australia.
Introduction:
Early laryngeal carcinomas may be treated by transoral laser microsurgery (TLM) or external beam radiotherapy. We review our experience of surgical treatment of laryngeal pre-malignant and malignant lesions over the past 15 years in a high-volume head neck unit.
Methods:
A review of a prospective patient database of patients with laryngeal SCC, who were treated with CO2 TLM between 2004 and 2019 was carried out.
Results:
83 patients with a mean age of 67.7 (SD: 10.6) years underwent primary curative TLM for T1a/b SCC. 5-year overall survival was 93.2% (95%CI 86.9-100%), disease free survival was 86.0% (95%CI 78.1-94.6%), locoregional control was 91.2% (95%CI: 85.1-97.7%) and larynx preservation rate of 95.1% at 5 years.
Conclusion:
TLM is an excellent treatment modality for T1 early glottic SCC, with excellent locoregional control and disease-free survival. It is minimally invasive, outpatient-based, and cost-effective procedure preserving upper aerodigestive tract dysfunction for all activities of daily living.
