Functional Outcomes of Supraglottic Squamous Cell Carcinoma Treated by Transoral Laser Microsurgery Compared with Horizontal Supraglottic Laryngectomy in Patients Younger and Older Than 65 Years

Overview

Journal Acta Otorhinolaryngol Ital

Specialty Otorhinolaryngology

Date 2017 Feb 9

PMID 28177327

Citations 9

Authors

C M Chiesa Estomba

F A Betances Reinoso

A I Lorenzo Lorenzo

J L Farina Conde

J Araujo Nores

C Santidrian Hidalgo

Affiliations

Soon will be listed here.

Abstract

The treatment of supraglottic carcinoma remains a controversial issue. Five accepted surgical and non-surgical oncological treatments have been currently established: standard horizontal supraglottic laryngectomy (HSL), supraglottic CO2 laser microsurgery (TLM), transoral robotic surgery, radiotherapy alone and radiotherapy in combination with chemotherapy. Some studies have shown that complications of head and neck surgeries increase significantly in patients over 65 years compared to younger patients. We designed a retrospective analysis to assess the rate of complications and functional outcomes of patients treated by TLM and HSL in cases of T1-T3 supraglottic squamous cell carcinomas (SCC) in a tertiary University Hospital. Results were compared between patients younger and older than 65 years. We found significant differences in the rate of aspiration pneumonia (p = 0.026), mean time to decannulation (p = 0.001) and mean hospital stay (p = 0.007) in patients treated by TLM, which was higher and longer in the group of patients over 65 years of age. Regarding HPL, we only found significant differences in the mean time to decannulation (p = 0.001), which was longer in the group of patients younger than 65 years. According to our results, TLM or HPL can both be a safe surgical option for patients older than 65 years, but previous evaluation of lung function before surgery is mandatory because of an increased risk of aspiration pneumonia in patients with lung problems, especially when treated by TLM. Concerning functional outcomes in patients older than 65 years, TLM reduces the postoperative rate of tracheostomy, mean time required for decannulation and mean hospital stay compared with HPL. However, no significant difference in the occurrence of aspiration pneumonia, dysphagia or in the mean length of NGT feeding was found.

Citing Articles

Development and validation of a machine learning model to predict the risk of lymph node metastasis in early-stage supraglottic laryngeal cancer.

Wang H, He Z, Xu J, Chen T, Huang J, Chen L Front Oncol. 2025; 15:1525414.

PMID: 40018413 PMC: 11865678. DOI: 10.3389/fonc.2025.1525414.

Transoral Laser Microsurgery and Transoral Robotic Surgery in Aging Patients: A State-of-The-Art Review.

Lechien J Clin Interv Aging. 2024; 19:2121-2132.

PMID: 39691799 PMC: 11651065. DOI: 10.2147/CIA.S475037.

Transoral Laser Microsurgery of Supraglottic Cancer: A Survival Analysis.

Abdi Sofi S, Dabirmoghaddam P, Aghazadeh K, Karimi E, Naderyan Feli S Iran J Otorhinolaryngol. 2024; 36(6):647-654.

PMID: 39650078 PMC: 11624849. DOI: 10.22038/ijorl.2024.75846.3543.

Transoral laser microsurgery for supraglottic carcinomas: results of a prospective multicenter trial (SUPRATOL).

Ambrosch P, Meuret S, Dietz A, Fazel A, Fietkau R, Tostmann R Front Oncol. 2024; 14:1440024.

PMID: 39372873 PMC: 11449847. DOI: 10.3389/fonc.2024.1440024.

Swallowing Outcomes in Open Partial Horizontal Laryngectomy Type I and Endoscopic Supraglottic Laryngectomy: A Comparative Study.

Saraniti C, Ciodaro F, Galletti C, Gallina S, Verro B Int J Environ Res Public Health. 2022; 19(13).

PMID: 35805718 PMC: 9265323. DOI: 10.3390/ijerph19138050.

References

Bussu F, Almadori G, De Corso E, Rizzo D, Rigante M, Parrilla C . Endoscopic horizontal partial laryngectomy by CO(2) laser in the management of supraglottic squamous cell carcinoma. Head Neck. 2009; 31(9):1196-206. DOI: 10.1002/hed.21085. View

Ansarin M, Zorzi S, Massaro M, Tagliabue M, Proh M, Giugliano G . Transoral robotic surgery vs transoral laser microsurgery for resection of supraglottic cancer: a pilot surgery. Int J Med Robot. 2013; 10(1):107-12. DOI: 10.1002/rcs.1546. View

Remacle M, Hantzakos A, Eckel H, Evrard A, Bradley P, Chevalier D . Endoscopic supraglottic laryngectomy: a proposal for a classification by the working committee on nomenclature, European Laryngological Society. Eur Arch Otorhinolaryngol. 2009; 266(7):993-8. DOI: 10.1007/s00405-008-0901-8. View

Leone C, Capasso P, Russo G, DErrico P, Cutillo P, Orabona P . Supracricoid laryngectomies: oncological and functional results for 152 patients. Acta Otorhinolaryngol Ital. 2015; 34(5):317-26. PMC: 4299161. View

Alon E, Kasperbauer J, Olsen K, Moore E . Feasibility of transoral robotic-assisted supraglottic laryngectomy. Head Neck. 2011; 34(2):225-9. DOI: 10.1002/hed.21719. View

Blanch J, Vilaseca I, Bernal-Sprekelsen M, Grau J, Moragas M, Traserra-Coderch J . Prognostic significance of surgical margins in transoral CO2 laser microsurgery for T1-T4 pharyngo-laryngeal cancers. Eur Arch Otorhinolaryngol. 2007; 264(9):1045-51. DOI: 10.1007/s00405-007-0320-2. View

Peters T, van der Laan B, Plaat B, Wedman J, Langendijk J, Halmos G . The impact of comorbidity on treatment-related side effects in older patients with laryngeal cancer. Oral Oncol. 2010; 47(1):56-61. DOI: 10.1016/j.oraloncology.2010.10.016. View

Hinerman R, Mendenhall W, Amdur R, Stringer S, Villaret D, Robbins K . Carcinoma of the supraglottic larynx: treatment results with radiotherapy alone or with planned neck dissection. Head Neck. 2002; 24(5):456-67. DOI: 10.1002/hed.10069. View

Vaughan C . Transoral laryngeal surgery using the CO2 laser: laboratory experiments and clinical experience. Laryngoscope. 1978; 88(9 Pt 1):1399-420. DOI: 10.1002/lary.1978.88.9.1399. View

10.

Shi R, Xu C, Zhang C, Jiang C, Sun Y, Yan X . Outcomes of laryngectomy in elderly patients with laryngeal carcinoma. Genet Mol Res. 2014; 13(1):1955-63. DOI: 10.4238/2014.March.17.23. View

11.

Ruberto M, Alicandri-Ciufelli M, Grammatica A, Marchioni D, Bergamini G, Presutti L . Partial laryngectomies: when the problem is the pexy. Acta Otorhinolaryngol Ital. 2014; 34(4):247-52. PMC: 4157537. View

12.

Bhattacharyya N, Fried M . Benchmarks for mortality, morbidity, and length of stay for head and neck surgical procedures. Arch Otolaryngol Head Neck Surg. 2001; 127(2):127-32. DOI: 10.1001/archotol.127.2.127. View

13.

Succo G, Bussi M, Presutti L, Cirillo S, Crosetti E, Bertolin A . Supratracheal laryngectomy: current indications and contraindications. Acta Otorhinolaryngol Ital. 2015; 35(3):146-56. PMC: 4510940. View

14.

Peretti G, Piazza C, Cattaneo A, De Benedetto L, Martin E, Nicolai P . Comparison of functional outcomes after endoscopic versus open-neck supraglottic laryngectomies. Ann Otol Rhinol Laryngol. 2006; 115(11):827-32. DOI: 10.1177/000348940611501106. View

15.

Weinstein G, OMalley Jr B, Snyder W, Hockstein N . Transoral robotic surgery: supraglottic partial laryngectomy. Ann Otol Rhinol Laryngol. 2007; 116(1):19-23. DOI: 10.1177/000348940711600104. View

16.

Zeitels S, Koufman J, Davis R, Vaughan C . Endoscopic treatment of supraglottic and hypopharynx cancer. Laryngoscope. 1994; 104(1 Pt 1):71-8. View

17.

Cabanillas R, Rodrigo J, Llorente J, Suarez V, Ortega P, Suarez C . Functional outcomes of transoral laser surgery of supraglottic carcinoma compared with a transcervical approach. Head Neck. 2004; 26(8):653-9. DOI: 10.1002/hed.20063. View

18.

Bussu F, Paludetti G, Almadori G, De Virgilio A, Galli J, Micciche F . Comparison of total laryngectomy with surgical (cricohyoidopexy) and nonsurgical organ-preservation modalities in advanced laryngeal squamous cell carcinomas: A multicenter retrospective analysis. Head Neck. 2012; 35(4):554-61. DOI: 10.1002/hed.22994. View

19.

Prgomet D, Bumber Z, Bilic M, Svoren E, Katic V, Poje G . Videofluoroscopy of the swallowing act after partial supraglottic laryngectomy by CO(2) laser. Eur Arch Otorhinolaryngol. 2002; 259(8):399-403. DOI: 10.1007/s00405-002-0485-7. View

20.

Maurizi M, Paludetti G, Galli J, Ottaviani F, DAbramo G, Almadori G . Oncological and functional outcome of conservative surgery for primary supraglottic cancer. Eur Arch Otorhinolaryngol. 1999; 256(6):283-90. DOI: 10.1007/s004050050247. View