Transoral CO2 Laser Resection of Laryngeal Cancer

Son, Seong Hwan; Lee, Kang Dae; Ha, Nam Wook; Kim, Sung Won; Lee, Hyoung Shin; Yoo, Tae Hyun; Lee, Hwan Ho

Abstract

BACKGROUND AND OBJECTIVES
Early stages of laryngeal carcinoma are usually treated with three different therapeutic options: partial or total laryngectomy, radiotherapy and transoral endoscopic CO2 laser partial laryngectomy. Combined use of CO2 laser and operating microscope, initially described by Strong and Jako in 1972, has been developed to a variety of procedures by many surgeons. The aim of this study was to define when laser resection of early stage laryngeal carcinoma is indicated and to compare the results obtained by laser surgery with other therapeutic options. MATERIALS AND METHOD: A retrospective study of 50 patients (glottic carcinoma 41 cases, supraglottic carcinoma 9 cases) treated between May, 1997 and March, 2003 at Department of Otolaryngology, Head and Neck Surgery of Kosin Medical College Hospital, was performed. Glottic cancers were treated with cordectomy type I to V, according to the classification proposed by the European Laryngological Society in 2000. Supraglottic cancer was treated with partial epiglottectomy, epiglottectomy, supraglottic partial laryngectomy, supraglottic laryngectomy, and extended supraglottic laryngectomy. RESULTS: The overall survival rate at 3 years was 100% for the glottic cancer (Tis, 3; T1a, 27; T1b, 5; T2, 2; rT1a, 3; rT2, 1) and local recurrence was identified in 1 patient, thus local control rate was 97.6%. Overall survival rate at 3 years was 100 % for the supraglottic cancer (T1, 3; T2, 2; T3, 1; rT2, 2; rT3, 1) and local control rate was 100%. CONCLUSION: Our results suggest that transoral endoscopic laser resection is a cost-effective procedure with good oncologic results and has acceptable functional results in early laryngeal carcinoma.