PMID- 34233029
OWN - NLM
STAT- MEDLINE
DCOM- 20220214
LR  - 20220731
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Print)
IS  - 0023-852X (Linking)
VI  - 132
IP  - 1
DP  - 2022 Jan
TI  - Transoral Laser Microsurgery for Glottic Cancer in Patients Over 75 Years Old.
PG  - 135-141
LID - 10.1002/lary.29738 [doi]
AB  - OBJECTIVES/HYPOTHESIS: Laryngeal squamous cell carcinoma (LSCC) has a 
      non-negligible incidence in elderly patients. However, there is still no clear 
      indication on the ideal treatment for early-intermediate glottic LSCC in this 
      specific age group. Both surgical and nonsurgical approaches may be burdened by 
      complications and sequelae that negatively impact patient's health. In this 
      setting, carbon dioxide transoral laser microsurgery (CO(2) TOLMS) is a promising 
      minimally invasive treatment option. STUDY DESIGN: Retrospective case series in a 
      single tertiary academic institution. METHODS: Patients who underwent CO(2) TOLMS 
      for Tis-T3 glottic LSCC from 1997 to 2017 were reviewed. Demographic, clinical, 
      and tumor characteristics, as well as postoperative complications were recorded. 
      Overall (OS), disease-specific (DSS), recurrence-free (RFS), laryngo-esophageal 
      dysfunction free survivals (LEDFS), and organ preservation (OP) were calculated. 
      RESULTS: A total of 134 patients (mean age, 80 +/- 4 years; median, 79; range, 
      75-93) were included in the study. Seven lesions were classified as pTis, 65 as 
      pT1a, 22 as pT1b, 35 as pT2, and 5 as pT3. No treatment-related death was 
      observed. Twenty-eight (20.9%) patients reported 10 surgical and 19 medical 
      complications. Five-year OS, DSS, RFS, LEDFS, and OP were 68.9%, 95.4%, 79.5%, 
      66%, and 92.5%, respectively. Age and comorbidities were associated with OS and 
      LEDFS. Advanced T categories were negatively correlated with OS, DSS, RFS, LEDFS, 
      and OP. Age and comorbidities were not significant risk factors for 
      complications. CONCLUSIONS: CO(2) TOLMS can be considered a valuable therapeutic 
      approach for selected Tis-T3 glottic LSCC even in the elderly given its favorable 
      oncologic outcomes and minimal aggressiveness. LEVEL OF EVIDENCE: 4 Laryngoscope, 
      132:135-141, 2022.
CI  - (c) 2021 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf 
      of The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Paderno, Alberto
AU  - Paderno A
AUID- ORCID: 0000-0002-1621-2142
AD  - Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili, Brescia, 
      Italy.
AD  - Department of Surgical and Radiological Sciences and Public Health, University of 
      Brescia, Brescia, Italy.
FAU - Lancini, Davide
AU  - Lancini D
AUID- ORCID: 0000-0002-3525-3118
AD  - Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili, Brescia, 
      Italy.
FAU - Bosio, Paolo
AU  - Bosio P
AD  - Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili, Brescia, 
      Italy.
AD  - Department of Surgical and Radiological Sciences and Public Health, University of 
      Brescia, Brescia, Italy.
FAU - Del Bon, Francesca
AU  - Del Bon F
AD  - Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili, Brescia, 
      Italy.
FAU - Fior, Milena
AU  - Fior M
AD  - Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili, Brescia, 
      Italy.
AD  - Department of Surgical and Radiological Sciences and Public Health, University of 
      Brescia, Brescia, Italy.
FAU - Berretti, Giulia
AU  - Berretti G
AD  - Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili, Brescia, 
      Italy.
AD  - Department of Surgical and Radiological Sciences and Public Health, University of 
      Brescia, Brescia, Italy.
FAU - Alparone, Marco
AU  - Alparone M
AD  - Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili, Brescia, 
      Italy.
AD  - Department of Surgical and Radiological Sciences and Public Health, University of 
      Brescia, Brescia, Italy.
FAU - Deganello, Alberto
AU  - Deganello A
AUID- ORCID: 0000-0003-1008-7333
AD  - Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili, Brescia, 
      Italy.
AD  - Department of Surgical and Radiological Sciences and Public Health, University of 
      Brescia, Brescia, Italy.
FAU - Peretti, Giorgio
AU  - Peretti G
AD  - Unit of Otorhinolaryngology-Head and Neck Surgery, IRCCS Ospedale Policlinico San 
      Martino, Genoa, Italy.
FAU - Piazza, Cesare
AU  - Piazza C
AUID- ORCID: 0000-0002-2391-9357
AD  - Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili, Brescia, 
      Italy.
AD  - Department of Surgical and Radiological Sciences and Public Health, University of 
      Brescia, Brescia, Italy.
LA  - eng
PT  - Journal Article
DEP - 20210707
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Squamous Cell/*surgery
MH  - Disease-Free Survival
MH  - Female
MH  - Glottis/*surgery
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Laryngeal Neoplasms/*surgery
MH  - Laser Therapy/*methods
MH  - Male
MH  - Retrospective Studies
MH  - Survival Analysis
PMC - PMC9291037
OTO - NOTNLM
OT  - Laryngeal cancer
OT  - complication
OT  - elderly
OT  - glottis
OT  - laser
OT  - oncologic outcome
OT  - transoral surgery
EDAT- 2021/07/08 06:00
MHDA- 2022/02/15 06:00
PMCR- 2022/07/18
CRDT- 2021/07/07 17:24
PHST- 2021/06/16 00:00 [revised]
PHST- 2021/02/27 00:00 [received]
PHST- 2021/06/28 00:00 [accepted]
PHST- 2021/07/08 06:00 [pubmed]
PHST- 2022/02/15 06:00 [medline]
PHST- 2021/07/07 17:24 [entrez]
PHST- 2022/07/18 00:00 [pmc-release]
AID - LARY29738 [pii]
AID - 10.1002/lary.29738 [doi]
PST - ppublish
SO  - Laryngoscope. 2022 Jan;132(1):135-141. doi: 10.1002/lary.29738. Epub 2021 Jul 7.