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Transoral laser microsurgery for T1 glottic cancer with anterior commissure: Identifying clinical and radiological variables that predict oncological outcome.
Eker, Caglar; Surmelioglu, Ozgur; Dagkiran, Muhammed; Kaya, Omer; Tanrisever, Ilda; Arpaci, Burak; Kaya, Bedir; Yucel Karakaya, Sevinc Puren; Onan, Elvan.
Afiliación
  • Eker C; Faculty of Medicine, Department of Otolaryngology and Head and Neck Surgery, Cukurova University, Campus of Balcali, Saricam, 01330, Adana, Turkey. drcaglareker@gmail.com.
  • Surmelioglu O; Faculty of Medicine, Department of Otolaryngology and Head and Neck Surgery, Cukurova University, Campus of Balcali, Saricam, 01330, Adana, Turkey.
  • Dagkiran M; Faculty of Medicine, Department of Otolaryngology and Head and Neck Surgery, Cukurova University, Campus of Balcali, Saricam, 01330, Adana, Turkey.
  • Kaya O; Faculty of Medicine, Department of Radiology, Cukurova University, Adana, Turkey.
  • Tanrisever I; Faculty of Medicine, Department of Otolaryngology and Head and Neck Surgery, Cukurova University, Campus of Balcali, Saricam, 01330, Adana, Turkey.
  • Arpaci B; Faculty of Medicine, Department of Otolaryngology and Head and Neck Surgery, Cukurova University, Campus of Balcali, Saricam, 01330, Adana, Turkey.
  • Kaya B; Faculty of Medicine, Department of Radiology, Cukurova University, Adana, Turkey.
  • Yucel Karakaya SP; Faculty of Medicine, Department of Biostatistics, Cukurova University, Adana, Turkey.
  • Onan E; Faculty of Medicine, Department of Otolaryngology and Head and Neck Surgery, Cukurova University, Campus of Balcali, Saricam, 01330, Adana, Turkey.
Eur Arch Otorhinolaryngol ; 281(5): 2597-2608, 2024 May.
Article en En | MEDLINE | ID: mdl-38424299
ABSTRACT

PURPOSE:

The involvement of the anterior commissure (AC) is regarded to be a risk factor for poor results after transoral laser microsurgery (TLM) for early glottic cancer. The objective of this study was to determine how AC-related clinical and radiological factors affected oncological outcomes in a cohort of patients with T1 stage early glottic carcinoma involving the anterior commissure who were treated with TLM with negative surgical margins.

METHODS:

Retrospective analysis was performed on clinical, radiological, and follow-up data of patients consecutively treated with TLM at a tertiary academic center between November 2011 and August 2021 for T1 glottic squamous cell carcinoma involving the anterior commissure. Recurrence-free survival (RFS), local control with laser alone (LCL), laryngeal preservation (LP), and overall survival (OS) rates (Kaplan-Meier) were the primary outcome metrics.

RESULTS:

In our series, 5-year OS probability was 75.1%, RFS was 64.8%, LCL was 73.8%, and LP was 83.4%. OS and RFS were higher in patients with early stages of AC pattern than in patients with advanced stage (p = 0.004, p = 0.034, respectively). Vertical extension ratio was found to be associated with OS and RFS (p = 0.023, p = 0.001, respectively), and thyroid cartilage interlaminar angle with LCL by multiple Cox regression analysis (p = 0.041).

CONCLUSION:

TLM remains a valuable treatment option for AC involvement. AC3 type involvement and elevated vertical extension ratio were associated with negative prognosis. There have been signs that thyroid cartilage with a narrow angle increases recurrence. Alternative modalities should be kept in mind in the treatment decision of these cases.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Lengua / Carcinoma de Células Escamosas / Neoplasias Laríngeas / Terapia por Láser / Neoplasias de Cabeza y Cuello Límite: Humans Idioma: En Revista: Eur Arch Otorhinolaryngol Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Turquía Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Lengua / Carcinoma de Células Escamosas / Neoplasias Laríngeas / Terapia por Láser / Neoplasias de Cabeza y Cuello Límite: Humans Idioma: En Revista: Eur Arch Otorhinolaryngol Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Turquía Pais de publicación: Alemania