Treatment of glottic cancer involving the anterior commissure by transoral CO2 laser surgery
10.3760/cma.j.issn.1673-0860.2017.05.004
- VernacularTitle: 经口CO2激光手术治疗前连合受累的声门型喉癌疗效观察
- Author:
Jingjia LI
1
;
Jianli ZHANG
1
;
Fayao HE
1
;
Sucheng TANG
1
;
Zhaofeng ZHU
1
;
Weixiong CHEN
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, First People′s Hospital of Foshan, Foshan 528000, China
- Publication Type:Journal Article
- Keywords:
Laryngeal neoplasms;
Glottis;
Carcinoma, squamons cell;
Lasers, gas;
Prognosis
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2017;52(5):337-342
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the clinical outcome of transoral CO2 laser surgery for glottic cancer involving the anterior commissure.
Methods:Thirty-two cases of glottic cancer involving the anterior commissure treated by transoral CO2 laser surgery between March 2009 and December 2013 were retrospectively reviewed. Among these cases, 27 were T1bM0M0, 5 were T2N0M0. All cases were followed-up for more than 3 years.
Results:All the 32 cases were successfully treated. Perioperative complications included injuries in the soft palate mucosa(13/32, 40.63%), loose incisors(3/32, 9.38%) and subcutaneous emphysema in the neck(2/32, 6.25%). During the follow-up period, granulation was found in all cases. Three cases had local recurrence. Two patients treated by a secondary transoral CO2 laser surgery and the other case had total laryngectomy, all three cases were followed up for 5 years without recurrence. Two cases had regional recurrence but no primary site recurrence. One patient was treated by neck dissection, and followed up for 5 years without recurrence. The other patient died of supraclavicular and mediastinal lymph node metastasis and lung metastasis 40 months after operation. The overall 5-year survival rate was 90.6%. There was no significant difference in survival rate between T1bN0M0(92.6%) and T2N0M0(80.0%) (Log Rank χ2=0.788, P=0.375). The overall 5-year local regional control rate was 84.4%. In T1bN0M0 lesions, the 5-year local regional control rate was 92.6%, which was significantly higher than that in T2N0M0 lesions(40.0%) (Log Rank χ2=9.504, P=0.002).
Conclusion:With appropriate surgical indication, detailed preoperative evaluation, good surgical skill, transoral CO2 laser surgery may achieve satisfactory outcome in the treatment of glottic cancer involving the anterior commissure.
