Awake endoscopic laser surgery for early glottic carcinoma

Area of Science:

• Otolaryngology
• Oncologic Surgery
• Laryngeal Cancer Treatment

Background:

• Early glottic carcinoma requires effective and minimally invasive treatment options.
• Traditional treatments may involve radiotherapy or transoral microsurgery, carrying potential risks and side effects.
• Awake endoscopic laryngeal surgery presents a potentially less invasive alternative under local anesthesia.

Purpose of the Study:

• To evaluate the oncologic efficacy and safety of awake endoscopic laryngeal surgery for T1-T2 glottic carcinoma.
• To assess outcomes such as disease control, larynx preservation, and recurrence rates.
• To identify patient groups who may benefit most from this minimally invasive approach.

Main Methods:

• Retrospective study of 71 patients with T1-T2 glottic carcinoma.
• Treatment involved awake flexible endoscopic laryngeal surgery under local anesthesia and mild sedation.
• Tumor ablation primarily used Nd:YAG laser, with some cases also involving diathermy snare excision.

Main Results:

• High rates of ultimate disease control (94.4%) and cure without recurrence (84.5%) were achieved.
• Larynx preservation was successful in 93.0% of patients.
• At 5 years, 74.6% of patients were alive and disease-free, with optimal results in the T1a subgroup.

Conclusions:

• Awake endoscopic laryngeal surgery is a safe and oncologically effective treatment for early glottic carcinoma.
• It offers a viable alternative for patients with contraindications to radiotherapy or general anesthesia.
• This office-based approach can improve patient compliance and reduce risks associated with traditional treatments.