The Laryngoscope · 2008
The utility of second-look operation after laser microresection of glottic carcinoma involving the anterior commissure.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Roh Jong-Lyel, Kim Dong-Hyun, Park Chan Il
Аннотация
OBJECTIVES/HYPOTHESIS: Transoral laser microsurgery for the treatment of glottic carcinoma with anterior commissure (A-com) involvement is associated with a high rate of recurrence. We prospectively evaluated the outcomes of laser microsurgery and the efficacy of second-look operation in these patients.
STUDY DESIGN: Prospective evaluation.
METHODS: Twenty-seven patients with glottic carcinomas involving the A-com underwent transoral laser microresection. Twenty-five patients underwent second-look operations 3 months after laser surgery.
RESULTS: After transoral laser microresection, all patients achieved microscopic clear resection margins. Local recurrence was found in 7 of 27 patients (25.9%). Regional recurrence was found in two patients. Patients with recurrences underwent laser re-resection or neck dissection; four received radiotherapy, two lost their larynxes, and three died of disease. At second-look operation, early local recurrence was found in two patients, and anterior glottic webs and granulomas causing dysphonia were treated in 8 and 11 patients, respectively.
CONCLUSIONS: Laser microsurgery is an effective treatment modality in early glottic cancer with A-com involvement but is still associated with a high rate of recurrence. Second-look operation may help detect early local recurrence and treat postoperative airway or voice problems.
STUDY DESIGN: Prospective evaluation.
METHODS: Twenty-seven patients with glottic carcinomas involving the A-com underwent transoral laser microresection. Twenty-five patients underwent second-look operations 3 months after laser surgery.
RESULTS: After transoral laser microresection, all patients achieved microscopic clear resection margins. Local recurrence was found in 7 of 27 patients (25.9%). Regional recurrence was found in two patients. Patients with recurrences underwent laser re-resection or neck dissection; four received radiotherapy, two lost their larynxes, and three died of disease. At second-look operation, early local recurrence was found in two patients, and anterior glottic webs and granulomas causing dysphonia were treated in 8 and 11 patients, respectively.
CONCLUSIONS: Laser microsurgery is an effective treatment modality in early glottic cancer with A-com involvement but is still associated with a high rate of recurrence. Second-look operation may help detect early local recurrence and treat postoperative airway or voice problems.