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Supraglottic CO2 laser laryngectomy: Real-world outcomes from a single-institution cohort
Carlos M Chiesa-Estomba1, Maria Landa-Garmendia1, Alfonso Rodriguez-Urzay1
1Osakidetza, Donostia University Hospital, Department of Otorhinolaryngology, Biodonostia Research Institute, 20014 San Sebastian, Spain.
Introduction:
Supraglottic laryngeal cancers often present at advanced stages and carry poorer prognoses than glottic tumors. Transoral CO₂ laser microsurgery (TOLMS) offers a minimally invasive, organ-preserving alternative, but functional morbidity remains a challenge.
Materials & Methods:
To evaluate oncological and functional outcomes of supraglottic partial CO₂ laser laryngectomy in a single-institution. Thirty-six patients treated with supraglottic partial CO₂ laser laryngectomy were analyzed retrospectively. Demographic, clinical, surgical, oncological, and functional outcomes were reviewed. Survival was analyzed using Kaplan-Meier estimates, and differences were tested with the log-rank test.
Results:
Mean age was 64 ± 8 years, with 83.3% male patients. Most tumors were pT2 (47.2%). Free surgical margins were achieved in 69.4% of cases. Three-year overall and disease-specific survival rates were 63.9% and 69.4%, respectively. Persistent gastrostomy dependence was observed in 3 (8.3%) patients. Tracheostomy was required in 4 (11.1%) patients, with persistent tracheostomy required in just 1 (2.8%) patient.
Conclusions:
Supraglottic partial CO₂ laser laryngectomy offers oncologic outcomes comparable to published series. However, functional morbidity remains significant and warrants careful patient selection and preoperative counseling.
