Transoral Laser Surgery for Laryngeal Cancer: Outcome, Complications and Prognostic Factors in 275 Patients

Eur J Surg Oncol. 2009 Mar;35(3):235-40. doi: 10.1016/j.ejso.2008.01.012. Epub 2008 Feb 20.

Abstract

Aim: Curative treatment options for laryngeal carcinoma include primary radiation therapy, open surgical techniques and transoral laser surgery (TLS). In the last decade, TLS has become an important tool in the treatment of laryngeal cancer and has become the standard approach in many institutions. The aim of this study was to review the experience of a single center institution with TLS for early and advanced laryngeal cancer.

Methods: We retrospectively analyzed 275 patients who underwent TLS in regard to the survival outcome and surgical complications.

Results: The 5-year disease-free survival estimate was 90.3% and the 10-year disease-free survival estimate was 88.2%. The 5-year larynx preservation rate estimate was 88.2% and the 10-year larynx preservation rate estimate was 87.3%. The disease-free survival was significantly worsened by the variables T and N (p=0.0003; p<0.001, respectively). Two percent of all patients required intraoperative tracheostomy and the rate of minor postoperative complications was 17%. There were no fatal complications.

Conclusions: We conclude that TLS is a valid treatment method for early laryngeal carcinoma. Selected cases of advanced carcinomas may also benefit from TLS.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laser Therapy / methods*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Postoperative Complications
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome