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VOLUME 2 , ISSUE 3 ( September-December, 2010 ) > List of Articles


Oncological Outcome of Transoral Laser Surgery in Laryngeal Carcinomas

H Sadick, K Hörmann

Keywords : Laryngeal carcinoma,transoral laser surgery,radiochemotherapy

Citation Information : Sadick H, Hörmann K. Oncological Outcome of Transoral Laser Surgery in Laryngeal Carcinomas. Int J Otorhinolaryngol Clin 2010; 2 (3):237-240.

DOI: 10.5005/jp-journals-10003-1042

Published Online: 01-04-2011

Copyright Statement:  Copyright © 2010; The Author(s).


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.

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  1. The advantages of laser treatment of tumors of the larynx. Oncology 1988;2(9):58–61;64-65.
  2. Endoscopic laser management of supraglottic cancer. Am J Otolaryngol 199516:2–11.
  3. Endoscopic treatment of supraglottic and hypopharynx cancer. Laryngoscope 1994;104:71–78.
  4. Minimally invasive therapy in otorhinolaryngology and head and neck surgery. Minimally Invasive Therapy 1991;1:57–70.
  5. Carbon dioxide laser microsurgery for early supraglottic carcinoma. Ann Otol Rhinol Laryngol 1998;107:680–88.
  6. Functional results after CO2 laser surgery compared with conventional phonosurgery. J Laryngol Otol 1999;113:140–44.
  7. Vocal function following laser and conventional surgery of small malignant vocal fold tumours. J Laryngol Otol 1996;110:1138–41.
  8. CO2 laser versus conventional microlaryngoscopy in benign changes of the vocal cords. Laryngorhinootologie 1997;76:484–89.
  9. Endoscopic resections of glottic and supraglottic carcinomas with the CO2 laser. Eur Arch Otorhinolaryngol 1995;252:146–48.
  10. Combined surgery and postoperative radiation therapy for advanced laryngeal and hypopharyngeal carcinomas. Int J Radiation Oncology Biol Phys 1984;11:499–504.
  11. Treatment of supraglottic cancer by radical high dose radiotherapy. Cancer 1974;33:1253–62.
  12. Radiotherapeutic management of cancer of the glottis. University of Virginia 1956-1971. Laryngoscope 1975;85:1494–503.
  13. Prognostic factors in supraglottic carcinoma patients treated by surgery or radiotherapy. Ann Otol Rhinol Laryngol 1998;107:697–702.
  14. Five hundred cancers of the larynx and pyriform sinus. Results of treatment by radiation and surgery. Laryngoscope 1977;87:1288–303.
  15. Vorläufige Ergebnisse der endolaryngealen Laserresektionen von Kehlkopfkarzinomen. HNO 1990;38:179–83.
  16. Laser surgery for the treatment of larynx carcinomas: Indications, techniques, and preliminary results. Ann Otol Rhinol Laryngol 1992;101:113–18.
  17. Experience in endoscopic laser surgery of malignant tumours of the upper aerodigestive tract. Adv Oto-Rhino-Laryng 1988;39:135–44.
  18. Results of curative laser microsurgery of laryngeal carcinomas. Am J Otolaryngol 1993;14:116–21.
  19. Transorale, lasermikrochirurgische Behandlung fortgeschrittener Larynxkarzinome Als Alternative Zur Laryngektomie, in Dühmke E, Steiner W, Reck R (Eds): Funktionserhaltende Therapie Des Fortgeschrittenen Larynxkarzinoms. Stuttgart, Thieme 1991:1–30.
  20. Transoral laser surgery of supraglottic cancer. Arch Otolaryngol Head Neck Surg 1998;124:1245–50.
  21. Preliminary oncological results of a multimodality treatment regimen with transoral laser surgery, neck dissection and postoperative irradiation in advanced laryngeal carcinomas. Onkologie 2000;23:246–50.
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