[Partial endoscopic resection with the CO2 laser in laryngeal carcinomas. II. Results]

This study presents the results of CO2 laser surgery in the curative treatment of 114 carcinomas of the vocal cord (Tis:8, T1a:88, T1b:10, T2:8) and 30 supraglottic carcinomas (T1:4, T2:11, T3:8, T4:7). In 21 patients with supraglottic carcinomas, additional radiotherapy was applied. Eleven patients underwent neck dissection. For the group of vocal cord carcinomas, 104 of 114 patients were free of recurrences after laser surgery. The ten recurrences were treated by irradiation (n = 3), repeated laser surgery (n = 3), and salvage laryngectomy (n = 3). One patient refused further treatment and died tumor related. 113 of 114 patients with glottic are without evidence of disease. For the group of patients with supraglottic carcinomas, six patients died without evidence of local disease. Two patients died of secondary malignancy without evidence of local recurrence. Four patients died of their tumor. Today, eighteen patients are without evidence of local or metastatic disease. In fourteen of these patients, the follow-up is longer than two years. Our data indicate that the oncological outcome after laser surgery is comparable to conventional open partial resection, whereas the functional outcome especially in supraglottic carcinomas is superior following laser surgery. In comparison to radiotherapy, the oncological outcome after laser surgery is better and functional results are only slightly inferior. Laser surgery should therefore take its place as an established treatment of supraglottic and glottic carcinomas.