Is There a Change in the Treatment of T1 Glottic Cancer After CO Laser? A Comparative Study with Cold Steel

Overview

Journal Turk Arch Otorhinolaryngol

Publisher Galenos Publishing House

Specialty Otorhinolaryngology

Date 2018 Sep 11

PMID 30197801

Citations 2

Authors

Uygar Levent Demir

Turgut Cevik

Fikret Kasapoglu

Affiliations

Soon will be listed here.

Abstract

Objective: Carbon dioxide (CO) laser provides high local control and disease-specific survival rates with minor morbidity and good quality of life in transoral cordectomy. We aimed to compare the oncological outcome and survival between cold steel and CO laser in the treatment of early glottic cancer.

Methods: In this retrospective study, the participants were divided into two groups. The first group comprised patients who were operated upon between 2001 and 2007 using cold steel (group 1, n=38), and the second group comprised patients who were operated upon between 2008 and 2016 using CO laser (group 2, n=88). Both groups were compared regarding age, gender, pathological grade, T stage, type of cordectomy, margin status, anterior commissure involvement, follow-up, locoregional recurrence, and disease-free survival (DFS).

Results: The overall survival rate and DFS were similar between the two groups (94.7% vs. 98.9% and 100% vs. 98.9%, respectively), and no association was found between surgical margin positivity and local recurrence. However, a significant association between the presence of anterior commissure involvement and recurrence was found in all 126 patients (p=0.016). Local recurrence was significantly higher in the group 2 (p=0.024), but it did not affect overall survival and DFS in these patients (100% vs. 94.1%).

Conclusion: Although CO laser excision is considered to be superior to cold steel regarding surgical time and bleeding control, the local recurrence rates were found to be higher with the laser than the cold steel. Thus, we argue that cases should be selected more carefully concerning the anterior commissure, depth of tumor invasion lateral to vocal muscle, difficulty at endoscopic exposure for lesions with anterior commissure involvement, and reliability of surgical margins at frozen sections.

Citing Articles

CO LASER versus Blade Scalpel Surgery in the Management of Nasopharyngeal Masses in Dogs.

Carreira L, Alexandre-Pires G, Azevedo P Animals (Basel). 2024; 14(12).

PMID: 38929352 PMC: 11200637. DOI: 10.3390/ani14121733.

Prognosis and Outcomes in Early Stage Glottic Carcinoma Involving the Anterior Commissure Treated with Laser CO Surgery: A Retrospective Observational Analysis.

Carreras A, Martinez-Torre M, Zabaleta M, Sanchez-Del-Rey A, Santaolalla F, Diaz-de-Cerio P Indian J Otolaryngol Head Neck Surg. 2023; 74(Suppl 3):6048-6053.

PMID: 36742721 PMC: 9895331. DOI: 10.1007/s12070-021-02698-3.

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