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KMID : 0356820020180010036
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Korean Journal of Head & Neck Oncology
2002 Volume.18 No. 1 p.36 ~ p.40
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Endoscopic Laser Surgery in Laryngeal Carcinoma
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김광현
성명훈/이효정/이동욱/박범정/성원진/민양기/이철희/이재서/이상준/노종열
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Abstract
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Background and Objectives: To determine if laser endoscopic microsurgery is a reliable and appropriate approach in the treatment of laryngeal carcinomas.
Materials and Methods: Retrospective study of 62 patients treated with CO2 laser from June 1988 to November 2000 at Seoul National University Hospital for laryngeal squamous cell carcinoma. All patients were treated with curative intention. Fifty three untreated patients with laryngeal carcinoma (39 glottic and 14 supraglottic carcinoma patients) had primary carbon dioxide laser microsurgery. Nine radiation failure patients were treated. Postoperative radiotheray was done for 17 patients. Neck dissection was performed simultaneously for 4 supraglottic cases with cervical nodal metastasis. Mean follow-up duration was 40 months.
Results: In primary laser surgery group, distribution of tumors (American Joint Committee on Cancer, 1997) were 38 cases with Tl, 13 cases with T2, 2 cases with T3. Cure rate was 88.7%(47/53) and local control rate was 92.5%(49/53). Larynx was preserved in 94%(50/53) of patients. The overall 5-year survival rate(Kaplan-Meier) was 81.5%. In radiation failure group, 56% of patients were recurred after laser surgery.
Conclusion: Laser surgery could be a better treatment modality for early laryngeal cancers and selected advanced cases. Additional radiation therapy should be considered if resection margin is not satisfactory.
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KEYWORD
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