PMID- 34818662
OWN - NLM
STAT- MEDLINE
DCOM- 20220907
LR  - 20220907
IS  - 1421-9921 (Electronic)
IS  - 0014-312X (Linking)
VI  - 63
IP  - 3
DP  - 2022
TI  - Oncological Outcomes of Transoral Laryngeal Microsurgery with Fiber-Optic Diode 
      Laser for Early Glottic Cancer: A Single-Center Experience.
PG  - 132-144
LID - 10.1159/000519718 [doi]
AB  - Backgroud/Objectives: Transoral laser laryngeal microsurgery (LTLM) has been 
      widely used in the treatment of early-stage glottic laryngeal squamous cell 
      carcinoma (LSCC) for the past few decades. Although T stage, tumor grade, 
      anterior commissure involvement, type of cordectomy, positive surgical margin, 
      and postoperative additional therapies were accused as the prognostic factors for 
      recurrence, there is still controversy about these data in the literature. The 
      purpose of this study was to evaluate the oncological results of our patients 
      with early glottic LSCC treated with LTLM as a single-modality therapy in a 
      single-center study. METHODS: Patients with early-stage (Tis-1-2/N0) glottic LSCC 
      who underwent LTLM as a primary treatment from 2011 to 2019 were retrospectively 
      reviewed. The clinicopathological factors and oncologic outcomes were analyzed. 
      RESULTS: One hundred and sixty-one patients were enrolled in this study. The 
      5-year overall (OS), disease-specific (DSS), disease-free (DFS), and 
      laryngectomy-free survival rates were 84.5%, 97.9%, 79.2%, and 93.5%, 
      respectively. The most common stage, histopathological type, and type of 
      endoscopic cordectomy were T1 stage, well-differentiated cancer, and type 2 
      cordectomy, respectively. A positive surgical margin was defined in 20 (12.4%) 
      patients. There was a significant relationship between histopathological grade 
      and positive surgical margins (p = 0.038). OS and DSS rates of "wait and see" 
      modality were lower, while DFS of radiotherapy was lower than that of other 
      treatment modalities in patients with positive surgical margins, but the 
      differences were not statistically significant. Nineteen (11.8%) patients had a 
      recurrence. DSS was statistically significantly lower in patients with recurrence 
      (p < 0.001). CONCLUSION: The results of our study showed that anterior commissure 
      involvement, surgical margin positivity, and higher T stage statistically did not 
      reduce survival rates in early-stage LSCC patients treated with LTLM. As the 
      histopathological grade of the tumor worsens, the risk of surgical margin 
      positivity increases. RT may have a negative effect on recurrence and organ 
      preservation in the additional treatment of patient with positive surgical 
      margins.
CI  - (c) 2021 S. Karger AG, Basel.
FAU - Korkmaz, Mehmet Hakan
AU  - Korkmaz MH
AD  - Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Yildirim 
      Beyazit University, Ankara, Turkey.
AD  - Department of Otolaryngology Head and Neck Surgery, Diskapi Yildirim Beyazit 
      Training and Research Hospital, University of Health Sciences Turkey, Ankara, 
      Turkey.
FAU - Bayir, Omer
AU  - Bayir O
AD  - Department of Otolaryngology Head and Neck Surgery, Diskapi Yildirim Beyazit 
      Training and Research Hospital, University of Health Sciences Turkey, Ankara, 
      Turkey, bayiromer@hotmail.com.
FAU - Hatipoglu, Esra Bozkurt
AU  - Hatipoglu EB
AD  - ENT Clinic, Denizli State Hospital, Denizli, Turkey.
FAU - Tatar, Emel Cadalli
AU  - Tatar EC
AD  - Department of Otolaryngology Head and Neck Surgery, Diskapi Yildirim Beyazit 
      Training and Research Hospital, University of Health Sciences Turkey, Ankara, 
      Turkey.
FAU - Han, Unsal
AU  - Han U
AD  - Department of Pathology, Diskapi Yildirim Beyazit Training and Research Hospital, 
      University of Health Sciences, Ankara, Turkey.
FAU - Ocal, Bulent
AU  - Ocal B
AD  - Department of Otolaryngology Head and Neck Surgery, Diskapi Yildirim Beyazit 
      Training and Research Hospital, University of Health Sciences Turkey, Ankara, 
      Turkey.
FAU - Keseroglu, Kemal
AU  - Keseroglu K
AD  - Department of Otolaryngology Head and Neck Surgery, Diskapi Yildirim Beyazit 
      Training and Research Hospital, University of Health Sciences Turkey, Ankara, 
      Turkey.
FAU - Karahan, Sevilay
AU  - Karahan S
AD  - Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, 
      Turkey.
FAU - Saylam, Guleser
AU  - Saylam G
AD  - Department of Otolaryngology Head and Neck Surgery, Diskapi Yildirim Beyazit 
      Training and Research Hospital, University of Health Sciences Turkey, Ankara, 
      Turkey.
LA  - eng
PT  - Journal Article
DEP - 20211124
PL  - Switzerland
TA  - Eur Surg Res
JT  - European surgical research. Europaische chirurgische Forschung. Recherches 
      chirurgicales europeennes
JID - 0174752
SB  - IM
MH  - Humans
MH  - *Laryngeal Neoplasms/pathology/radiotherapy/surgery
MH  - Lasers, Semiconductor
MH  - Margins of Excision
MH  - Microsurgery/methods
MH  - Neoplasm Recurrence, Local
MH  - Neoplasm Staging
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Glottis
OT  - Laryngeal carcinoma
OT  - Laryngoscopic surgery
OT  - Laser surgery
OT  - Squamous cell carcinoma
OT  - Survival analysis
EDAT- 2021/11/25 06:00
MHDA- 2022/09/08 06:00
CRDT- 2021/11/24 20:10
PHST- 2021/06/27 00:00 [received]
PHST- 2021/09/16 00:00 [accepted]
PHST- 2021/11/25 06:00 [pubmed]
PHST- 2022/09/08 06:00 [medline]
PHST- 2021/11/24 20:10 [entrez]
AID - 000519718 [pii]
AID - 10.1159/000519718 [doi]
PST - ppublish
SO  - Eur Surg Res. 2022;63(3):132-144. doi: 10.1159/000519718. Epub 2021 Nov 24.