Abstract
There are several therapeutic options for laryngeal cancer, including those that provide a functional preservation without worsening the oncological results, such as transoral laser microsurgery (TLM). The aim of this study was to analyze both oncological and functional results of TLM in supraglottic cancer. We studied 49 consecutive patients with a primary supraglottic carcinoma who underwent a TLM between the years 1999 and 2009. Nineteen patients were classified as stage I–II and 30 as stage III–IV disease. Forty-five patients underwent also neck dissection. Thirteen patients received postoperative radiotherapy. The minimum follow-up was 24 months. Three- and five-year disease-specific survival rate was 93.2 and 82.2 %, respectively. Of the patients, 36.7 % had some complication after surgery, aspiration being the most frequent (16.32 %). Of the 43 patients who were alive, 39 (91 %) without evidence of disease 3 years after diagnosis had a functional larynx. Our results suggest that TLM is a safe and effective treatment for supraglottic cancer, with a low morbidity rate and excellent functional results.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Suarez C, Rodrigo JP, Silver CE, Hartl DM, Takes RP, Rinaldo A, Strojan P, Ferlito A (2011) Laser surgery for early to moderately advanced glottic, supraglottic, and hypopharyngeal cancers. Head Neck. doi:10.1002/hed.21766
Rodrigo JP, Suarez C, Silver CE, Rinaldo A, Ambrosch P, Fagan JJ, Genden EM, Ferlito A (2008) Transoral laser surgery for supraglottic cancer. Head Neck 30(5):658–666. doi:10.1002/hed.20811
Lopez-Alvarez F, Rodrigo JP, Llorente-Pendas JL, Suarez-Nieto C (2011) Transoral laser microsurgery in advanced carcinomas of larynx and pharynx. Acta Otorrinolaringol Esp 62(2):95–102. doi:10.1016/j.otorri.2010.09.008
Peretti G, Piazza C, Cattaneo A, De Benedetto L, Martin E, Nicolai P (2006) Comparison of functional outcomes after endoscopic versus open-neck supraglottic laryngectomies. Ann Otol Rhinol Laryngol 115(11):827–832
Cabanillas R, Rodrigo JP, Llorente JL, Suarez C (2008) Oncologic outcomes of transoral laser surgery of supraglottic carcinoma compared with a transcervical approach. Head Neck 30(6):750–755. doi:10.1002/hed.20778
Silver CE, Beitler JJ, Shaha AR, Rinaldo A, Ferlito A (2009) Current trends in initial management of laryngeal cancer: the declining use of open surgery. Eur Arch Otorhinolaryngol 266(9):1333–1352. doi:10.1007/s00405-009-1028-2
Edge SB, American Joint Committee on Cancer (2010) AJCC cancer staging manual, 7th edn. Springer, New York
Steiner W, Ambrosch P (2000) Endoscopic laser surgery of the upper aerodigestive tract: with special emphasis on cancer surgery. Thieme, Stuttgart
Rudert HH, Werner JA, Hoft S (1999) Transoral carbon dioxide laser resection of supraglottic carcinoma. Ann Otol Rhinol Laryngol 108(9):819–827
Lefebvre JL (2006) Laryngeal preservation in head and neck cancer: multidisciplinary approach. Lancet Oncol 7(9):747–755. doi:10.1016/S1470-2045(06)70860-9
Vaughan CW (1978) Transoral laryngeal surgery using the CO2 laser: laboratory experiments and clinical experience. Laryngoscope 88(9 Pt 1):1399–1420
Sevilla MA, Rodrigo JP, Llorente JL, Cabanillas R, Lopez F, Suarez C (2008) Supraglottic laryngectomy: analysis of 267 cases. Eur Arch Otorhinolaryngol 265(1):11–16. doi:10.1007/s00405-007-0415-9
Guzzo M, Ferraro L, Rezzonico S, Ibba T, Bianchi R, Fontanella W, Scaramellini G (2011) Open organ preservation surgery of the larynx: experience of Istituto Nazionale Tumori of Milan. Head Neck 33(5):673–678. doi:10.1002/hed.21519
Cabanillas R, Rodrigo JP, Llorente JL, Suarez V, Ortega P, Suarez C (2004) Functional outcomes of transoral laser surgery of supraglottic carcinoma compared with a transcervical approach. Head Neck 26(8):653–659. doi:10.1002/hed.20063
Kollisch M, Werner JA, Lippert BM, Rudert H (1995) Functional results following partial supraglottic resection. Comparison of conventional surgery vs. transoral laser microsurgery. Adv Otorhinolaryngol 49:237–240
Ambrosch P, Kron M, Steiner W (1998) Carbon dioxide laser microsurgery for early supraglottic carcinoma. Ann Otol Rhinol Laryngol 107(8):680–688
Blanch JL, Vilaseca I, Bernal-Sprekelsen M, Grau JJ, Moragas M, Traserra-Coderch J, Caballero M, Sabater F, Guilemany JM, Alos L (2007) Prognostic significance of surgical margins in transoral CO2 laser microsurgery for T1–T4 pharyngo-laryngeal cancers. Eur Arch Otorhinolaryngol 264(9):1045–1051. doi:10.1007/s00405-007-0320-2
Jackel MC, Ambrosch P, Martin A, Steiner W (2007) Impact of re-resection for inadequate margins on the prognosis of upper aerodigestive tract cancer treated by laser microsurgery. Laryngoscope 117(2):350–356. doi:10.1097/01.mlg.0000251165.48830.89
Rodrigo JP, Charlone R, Cabanillas R, Llorente JL, Suarez C (2008) Is it necessary to perform neck dissections as a staged procedure in laser supraglottic laryngectomy? Acta Otorrinolaringol Esp 59(7):345–348. pii: 13125865
Rigby MH, Taylor SM (2011) Review of transoral laser microsurgery for cancer of the upper aerodigestive tract. J Otolaryngol Head Neck Surg 40(2):113–121
Csanady M, Czigner J, Vass G, Jori J (2011) Transoral CO(2) laser management for selected supraglottic tumors and neck dissection. Eur Arch Otorhinolaryngol. doi:10.1007/s00405-011-1603-1
Acknowledgments
The study was supported by grants from ISCIII, RTICC (RD06/0020/0034) and Obra Social Cajastur-IUOPA.
Conflict of interest
The authors declare no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
González-Márquez, R., Rodrigo, J.P., Llorente, J.L. et al. Transoral CO2 laser surgery for supraglottic cancer. Eur Arch Otorhinolaryngol 269, 2081–2086 (2012). https://doi.org/10.1007/s00405-012-2016-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-012-2016-5