Preliminary Oncological Results of a Multimodality Treatment Regimen with Transoral Laser Surgery, Neck Dissection and Postoperative Irradiation in Advanced Laryngeal Carcinomas

2000 ◽  
Vol 23 (3) ◽  
pp. 246-250
Author(s):  
H. Sadick ◽  
F. Riedel ◽  
W. Bergler ◽  
K. Hörmann
2010 ◽  
Vol 2 (3) ◽  
pp. 237-240
Author(s):  
H Sadick ◽  
K Hörmann

Abstract The principles of treatment of laryngeal carcinoma have undergone changes over the last few years and can be very complex with early (I-II) and advanced (III-IV) stage diseases to be differentiated. Recent emphasis is on organ preservation and laryngeal function. Transoral CO2 laser surgery has become a standard surgical procedure not only in early stage I and II laryngeal carcinomas but also in advanced stage III cases in combination with postoperative adjuvante radiochemotherapy. This retrospective study reflects the role of transoral laser surgery as a single or multimodality treatment regime with neck dissection and postoperative radiochemotherapy in laryngeal carcinomas. From January 1997 to February 2007, 239 patients (215 men and 24 women; mean age 61 years) were examined with laryngeal squamous cell carcinoma (stage I-IV). 220 out of these 239 patients underwent transoral laser surgery, depending on their tumor stage either as a single or as a multimodality treatment regimen in combination with bilateral neck dissection and postoperative radio-chemotherapy. Thirteen patients underwent a transcervical tumor resection, 5 patients underwent radiochemotherapy alone and one patient refused a treatment of his tumor disease. Median follow-up time was 60 months. The 5-year overall survival rate of the 220 patients who were treated with laser surgery was 86%. The 5-year recurrence-free survival rate was 69.5%. After laser surgical interventions, postoperative complications occurred in 16%. The oncological outcome of transoral laser surgery as a single mode in early laryngeal carcinomas or in combination with bilateral neck dissection and postoperative adjuvant radiochemotherapy in advanced tumor stages is satisfying if clean surgical tumor margins (R0) can be reached. If tumor-free margins cannot be achieved (R1 and R2 resection) and transoral revision is not possible, transcervical procedures (total or partial laryngectomy) must be considered.


2021 ◽  
pp. 000348942110658
Author(s):  
Alison N. Hollis ◽  
Ameer Ghodke ◽  
Douglas Farquhar ◽  
Robert A. Buckmire ◽  
Rupali N. Shah

Objectives: Transoral laser surgery for glottic stenosis (transverse cordotomy and anteromedial arytenoidectomy (TCAMA)) is often complicated by granulation tissue (GT) formation. GT can cause dyspnea and may require surgical removal to alleviate airway obstruction. Inhaled corticosteroids (ICS) have been shown to reduce benign vocal fold granulomas, however its use to prevent GT formation has not been described. We aimed to analyze the effect of immediate postoperative ICS on GT formation in patients undergoing transoral laser surgery for glottic stenosis. Methods: A retrospective analysis of patients that had transoral laser surgery for glottic stenosis from 2000 to 2019 was conducted. Surgical instances were grouped into those that received postoperative ICS and those that did not. Demographics, diagnosis, comorbidities, intraoperative adjuvant therapy, and perioperative medications were collected. Differences in GT formation and need for surgical removal were compared between groups. A multivariate exact logistic regression model was performed. Results: Forty-four patients were included; 16 required 2 glottic airway surgeries (60 surgical instances). Of the 23 instances where patients received immediate postoperative ICS, 0 patients developed GT; and of the 37 instances that did not receive postoperative ICS, 15 (40.5%) developed GT ( P < .0001). Eight (53.3%) of these cases returned to the OR for GT removal. ICS use was solely associated with the absence of GT formation ( P = .042) in the multivariate analysis. Conclusions: Immediate postoperative use of ICS seems to be a safe and effective method to prevent granulation tissue formation and subsequent surgery in patients following transoral laser airway surgery for glottic stenosis.


2020 ◽  
Vol 2 (1) ◽  
pp. 01-04
Author(s):  
ALJ zineb

Tran’s oral laser surgery is at the forefront of the therapeutic arsenal of epidermoid glottic cancer, but its indications for certain local extensions are controversial. We have analyzed through a retrospective study of 37 patients with T1 or T2 epidermoid glottic carcinoma, treated with transoral laser surgery, the post-surgical outcomes regarding the relapse-free survival, local control rate, laryngeal preservation rate and overall survival, correlated to the initial local extension. This study aimed at clarifying further the clinical behavior of early glottic cancer following transoral laser surgery and to determine, using retrospective analysis, and the predictive factors of carcinological outcomes.


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P131-P131
Author(s):  
Jose A Pinto ◽  
Luciana Godoy ◽  
Valéria Marquis ◽  
Michelle Brunoro ◽  
Silvana Bellotto ◽  
...  

Objectives Report our experience in the endoscopic treatment of supraglottic cancer with CO2 laser. Show the outcome reached with laser microsurgery in the treatment of supraglottic cancer. Methods From 1990 to 2007, 19 patients with supraglottic cancer underwent CO2 laser microsurgery. Results There were 7 (36.8%) T1, 5 (26.4%) T2, and 7 (36.8%) T3. T1 and T2 supraglottic tumors underwent endoscopic surgery with CO2 laser. T2 stage patients also were submitted to unilateral neck dissection. 2 patients (10.5%) with early supraglottic cancers had recurrence (one local and cervical and another cervical metastasis submitted to external surgery). Supraglottectomy with CO2 laser was performed to analize the preepiglottic space and to allow tumor stage. All T3 supraglottic tumors had pre-epiglottic invasion and underwent external supraglottic laryngectomy with neck dissection. Conclusions Endoscopic treatment for laryngeal cancer is an efficient therapy for early supraglottic cancers and is the best method to evaluate the preepiglottic invasion. This therapy makes local function possible without prejudice to oncological results.


2010 ◽  
Vol 37 (5) ◽  
pp. 601-608 ◽  
Author(s):  
Guangbin Sun ◽  
Haihong Tang ◽  
Alicia J. Sprecher ◽  
Julia K. MacCallum ◽  
Na Sun ◽  
...  

2014 ◽  
Vol 5 (2) ◽  
pp. e0012 ◽  
Author(s):  
Vlad Sandulache ◽  
Michael Kupferman

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