Transoral laser microsurgery in treatment of pT2 and pT3 glottic laryngeal squamous cell carcinoma - results of 391 patients.

Background: The purpose of this study was to evaluate oncological and functional results of transoral laser microsurgery (TLM) in patients with T2 and T3 glottic laryngeal squamous cell carcinoma (SCC).
Methods: A retrospective chart analysis was carried out. Cases were classified into categories pT2a, pT2b, and pT3. Treatment was exclusively TLM ± selective neck dissection and adjuvant (chemo)radiotherapy.
Results: Three hundred ninety-one patients were treated by TLM; 142 cases were category pT2a, 127 were pT2b, and 122 were pT3. Median follow-up was 71 months. Five-year overall, recurrence-free, and disease specific survival rates were 72.2%, 76.4%, and 93.2% for pT2a tumors, 64.9%, 57.3%, and 83.9% for pT2b tumors, and 58.6%, 57.8%, and 84.1% for pT3 tumors, respectively. Larynx preservation was achieved in 93% (pT2a) and 83% (pT2b and pT3).
Conclusion: Results are comparable to open partial or total laryngectomy and superior to primary (chemo)radiotherapy. TLM results in a lower morbidity and superior function compared to standard treatment.
(© 2013 Wiley Periodicals, Inc.)