Three-Year Oncologic Outcomes of 445-nm TruBlue Laser Ablation for Early Glottic Cancer and Dysplasia

Early glottic cancer and laryngeal dysplasia are commonly managed with single-modality therapy. The 445-nm TruBlue laser (TBL) is an emerging photoangiolytic modality; however, data on its oncologic effectiveness remain limited. This study evaluates oncologic outcomes following TBL ablation for laryngeal dysplasia and early-stage glottic cancer.

Retrospective cohort study METHODS: We conducted a retrospective analysis of 66 adult patients with glottic dysplasia or early glottic cancer treated with TBL between February 2020 and July 2024 at a single academic center. Outcomes were assessed according to temporal and oncologic progression following TBL, including initial local disease control after the first TBL intervention, time to recurrence, iterative local disease control, TBL treatment failure, ultimate disease control attained by any modality, and survival outcomes.

The cohort included 42 patients with dysplasia and 24 with squamous cell carcinoma (SCC). Initial local disease control was achieved in 44 patients (66.7%). Among 22 patients without initial local disease control, 19 developed recurrence, and three had residual disease. The median time to recurrence was 8.7 months (interquartile range, 6.6-13.2). Following additional TBL procedures, iterative local disease control with TBL alone was achieved in 92.4% of patients, including 100% of dysplasia cases and 79.2% of SCC cases. Five patients (7.6%) required escalation to radiotherapy or CO₂ laser treatment. Ultimate disease control was achieved in all patients, with a laryngeal preservation rate of 100%.

TBL ablation provides effective oncologic control for laryngeal dysplasia and early glottic cancer, with high rates of iterative local disease control and excellent laryngeal preservation. These findings support its role as a viable organ-preserving treatment modality with favorable intermediate-term oncologic outcomes.