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KMID : 1037020130020010024
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Medical Lasers; Engineering, Basic Research, and Clinical Application
2013 Volume.2 No. 1 p.24 ~ p.28
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Treatment Outcome and Prognostic Factors of CO2 Laser Cordectomy for Early Glottic Cancer
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Kim Kwang-Hyun
Sung Myung-Whun
Baek Chung-Hwan
Son Young-Ik
Kim Sang-Yoon
Choi Seung-Ho
Lee Kang-Dae
Lee Sang-Joon
Chung Phil-Sang
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Abstract
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Background and Objectives: Laser cordectomy is now a popular method and is one of the treatments of choice for patients with early glottic carcinoma. Transoral laser microsurgery provides many advantages compared to conventional open surgery or radiation therapy. In this study, we examined the oncologic results of laser cordectomy for the treatment of early glottic cancer and analyzed its prognostic impact on the survival of the several tumorrelated and treatment-related factors.
Materials and Methods: Data of 202 patients from five hospitals who were diagnosed with early glottic squamous cell carcinoma and treated with curative intent by laser cordectomy from June 1988 to March 2005 were used for the analysis (174 T1, 28 T2). Patients who underwent radiation therapy previously were included.
Results: The five-year overall survival and disease-free survival rates were 98.4% and 84.9%, respectively. Twenty-two patients developed local recurrence. Total laryngectomy was performed in 6 patients and the laryngeal preservation rate in these patients was 97%. Recurrence was higher in the patients with anterior commissure involvement (9/39) than in those without anterior commissure involvement (13/163). Recurrence was higher in T1b (4/15) patients than those with T1a (13/159). Previous radiation was also found to be highly related to recurrence (7/20 vs 15/182). Twenty patients with local recurrence after radiation therapy were treated by salvage laser cordectomy. Of them, 7 patients developed local recurrence and the five-year disease-free survival rate was 57% in them. Complication was rare with just one case of hemorrhage. Tracheostomy was not necessary in all the patients.
Conclusion: Laser cordectomy for the treatment of early glottic carcinoma resulted in high survival, laryngeal preservation rate and low complication rate. The prognostic factors were anterior commissure involvement, vocal fold involvement and previous radiotherapy.
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KEYWORD
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Early glottic cancer, Laser cordectomy
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