Authors: Abie H Mendelsohn Devora Kiagiadaki Georges Lawson Marc Remacle
Publish Date: 2014/10/29
Volume: 272, Issue: 2, Pages: 413-418
Abstract
Transoral CO2 laser cordectomy for squamous cell carcinoma SCC of the glottis has resulted in excellent voice and oncologic outcomes as compared with nonsurgical therapy However published experience with primary CO2 laser cordectomy specifically for glottic SCC involving the anterior commissure AC is limited A review of single academic institution experience with CO2 laser cordectomy for glottic SCC involving the AC Patients undergoing European Laryngological Society ELS classification cordectomy type Va or type VI between 2005 and 2013 were included Postsurgical voice analysis was performed by speech language pathologists SLP from the reporting institution Thirty patients were identified for inclusion Mean postsurgical followup time was 476 months range 11–59 Initial local recurrence was identified in 5/30 167 patients 2/5 recurrences were successfully salvaged by repeat CO2 laser resections 2/5 ultimately required salvage total laryngectomy and 1/5 patient developed a second primary preventing further curative treatment Overall laryngeal preservation rate was 28/30 933 Overall survival of the study cohort was 967 Mean postoperative voice handicap index120 score was 369 SD = 214 Perceptual analysis performed on the GRBAS scale resulted in mean scores G = 21 SD = 09 R = 13 SD = 11 B = 16 SD = 12 Though cancers involving the AC represent an aggressive subgroup of glottic SCC CO2 laser cordectomy results in encouraging oncologic and voice outcomes without the need for further therapy in the majority of cases Clinical trials are encouraged to further define optimal treatment recommendations for glottic SCC involving the AC
Keywords: