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Oncological and functional outcome after surgical treatment of early glottic carcinoma without anterior commissure involvement.

Milovanovic J, Jotic A, Djukic V, Pavlovic B, Trivic A, Krejovic-Trivic S, Milovanovic A, Milovanovic A, Artiko V, Banko B - Biomed Res Int (2014)

Bottom Line: Clinical and oncological results were followed postoperatively.Voice quality after the treatment was assessed using multidimensional voice analysis 12 months after the treatment.Endoscopic laser surgery should be the first treatment of choice in treatment of early glottic carcinomas, though open approach through laryngofissure should be available for selected cases where anatomical factors present limiting adequate tumor removal.

View Article: PubMed Central - PubMed

Affiliation: Medical Faculty Belgrade, University of Belgrade, Belgrade, Serbia ; Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Pasterova 2, Belgrade, Serbia.

ABSTRACT

Introduction: Glottic carcinoma can be successfully diagnosed in its early stages and treated with high percentage of success. Organ preservation and optimal functional outcomes could be achieved with wide array of surgical techniques for early glottic cancer, including endoscopic approaches or open laryngeal preserving procedures, making surgery the preferred method of treatment of early glottic carcinoma in the last few years.

Material and methods: Prospective study was done on 59 patients treated for Tis and T1a glottic carcinoma over a one-year time period in a tertiary medical center. Patients were treated with endoscopic laser cordectomy (types II-IV cordectomies according to European Laryngological Society classification of endoscopic cordectomies) and open cordectomy through laryngofissure. Follow-up period was 60 months. Clinical and oncological results were followed postoperatively. Voice quality after the treatment was assessed using multidimensional voice analysis 12 months after the treatment.

Results: There were no significant differences between oncological and functional results among two groups of patients, though complications were more frequent in patients treated with open cordectomy.

Conclusion: Endoscopic laser surgery should be the first treatment of choice in treatment of early glottic carcinomas, though open approach through laryngofissure should be available for selected cases where anatomical factors present limiting adequate tumor removal.

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Related in: MedlinePlus

Five-year overall survival and recurrence-free and disease-specific survival.
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fig1: Five-year overall survival and recurrence-free and disease-specific survival.

Mentions: Five-year overall survival and recurrence-free and disease-specific survival were calculated according to Kaplan-Meier method (Figure 1). The follow-up period for patients was 60 months. Five-year overall survival for open cordectomy patients was 91% and for endoscopic laser cordectomy 96%. The log rank test did not show significant difference between groups (log rank = 0.04; P > 0.05). Five patients died during the duration of the study: 3 from cardiovascular diseases and one from pulmonary malignancy and none related with laryngeal malignancy. One patient treated with open cordectomy had anterior commissure recurrence with thyroid cartilage infiltration which required total laryngectomy in further treatment. Postoperatively, radiotherapy was conducted, but 45 months after his first treatment that patient died from laryngeal malignancy. Five-year recurrence-specific survival for open cordectomy patients was 91% and for endoscopic laser cordectomy was 92%, without significant differences between groups (log rank = 0.17; P > 0.05). Five-year disease-specific survival for open cordectomy patients was 97% and for endoscopic laser cordectomy was 100%. In three patients with recurrent disease, total laryngectomy was done, mainly due to localization of the recurrent tumor. In these patients, anterior commissure was involved and thyroid cartilage infiltrated, according to control CT scans. Laryngeal preservation was done in two patients, with partial vertical laryngectomies. Deglutition was preserved in all patients. Unilateral resection of ventricular folds which was done in some of the patients treated with types III and IV endoscopic laser cordectomy had no impact on swallowing.


Oncological and functional outcome after surgical treatment of early glottic carcinoma without anterior commissure involvement.

Milovanovic J, Jotic A, Djukic V, Pavlovic B, Trivic A, Krejovic-Trivic S, Milovanovic A, Milovanovic A, Artiko V, Banko B - Biomed Res Int (2014)

Five-year overall survival and recurrence-free and disease-specific survival.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4060788&req=5

fig1: Five-year overall survival and recurrence-free and disease-specific survival.
Mentions: Five-year overall survival and recurrence-free and disease-specific survival were calculated according to Kaplan-Meier method (Figure 1). The follow-up period for patients was 60 months. Five-year overall survival for open cordectomy patients was 91% and for endoscopic laser cordectomy 96%. The log rank test did not show significant difference between groups (log rank = 0.04; P > 0.05). Five patients died during the duration of the study: 3 from cardiovascular diseases and one from pulmonary malignancy and none related with laryngeal malignancy. One patient treated with open cordectomy had anterior commissure recurrence with thyroid cartilage infiltration which required total laryngectomy in further treatment. Postoperatively, radiotherapy was conducted, but 45 months after his first treatment that patient died from laryngeal malignancy. Five-year recurrence-specific survival for open cordectomy patients was 91% and for endoscopic laser cordectomy was 92%, without significant differences between groups (log rank = 0.17; P > 0.05). Five-year disease-specific survival for open cordectomy patients was 97% and for endoscopic laser cordectomy was 100%. In three patients with recurrent disease, total laryngectomy was done, mainly due to localization of the recurrent tumor. In these patients, anterior commissure was involved and thyroid cartilage infiltrated, according to control CT scans. Laryngeal preservation was done in two patients, with partial vertical laryngectomies. Deglutition was preserved in all patients. Unilateral resection of ventricular folds which was done in some of the patients treated with types III and IV endoscopic laser cordectomy had no impact on swallowing.

Bottom Line: Clinical and oncological results were followed postoperatively.Voice quality after the treatment was assessed using multidimensional voice analysis 12 months after the treatment.Endoscopic laser surgery should be the first treatment of choice in treatment of early glottic carcinomas, though open approach through laryngofissure should be available for selected cases where anatomical factors present limiting adequate tumor removal.

View Article: PubMed Central - PubMed

Affiliation: Medical Faculty Belgrade, University of Belgrade, Belgrade, Serbia ; Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Pasterova 2, Belgrade, Serbia.

ABSTRACT

Introduction: Glottic carcinoma can be successfully diagnosed in its early stages and treated with high percentage of success. Organ preservation and optimal functional outcomes could be achieved with wide array of surgical techniques for early glottic cancer, including endoscopic approaches or open laryngeal preserving procedures, making surgery the preferred method of treatment of early glottic carcinoma in the last few years.

Material and methods: Prospective study was done on 59 patients treated for Tis and T1a glottic carcinoma over a one-year time period in a tertiary medical center. Patients were treated with endoscopic laser cordectomy (types II-IV cordectomies according to European Laryngological Society classification of endoscopic cordectomies) and open cordectomy through laryngofissure. Follow-up period was 60 months. Clinical and oncological results were followed postoperatively. Voice quality after the treatment was assessed using multidimensional voice analysis 12 months after the treatment.

Results: There were no significant differences between oncological and functional results among two groups of patients, though complications were more frequent in patients treated with open cordectomy.

Conclusion: Endoscopic laser surgery should be the first treatment of choice in treatment of early glottic carcinomas, though open approach through laryngofissure should be available for selected cases where anatomical factors present limiting adequate tumor removal.

Show MeSH
Related in: MedlinePlus