Transoral laser microsurgery of recurrent early glottic cancer after radiation therapy: clinical feasibility and limitations.

OBJECTIVES

Transoral laser microsurgery (TLM) is an accepted alternative to open partial laryngectomy for selected glottic cancers, but its role in salvage of radiation failure is debated.

METHODS

The records of 18 patients treated by TLM for rT1 and rT2 glottic cancer after curative radiation therapy from 2002 to 2007 were retrospectively analyzed.

RESULTS

Of the 18 patients, 10 (56%) remained free of disease after the first TLM. The 5-year local control and laryngeal preservation rates showed better outcomes in rpT1 tumors than in rpT2 tumors (87.5% versus 16.6%, p = 0.02; and 87.5% versus 33.3%, p = 0.03, respectively). However, the 5-year overall survival and disease-specific survival rates showed no significant difference between rpT1 and rpT2 tumors.

CONCLUSIONS

TLM can be a relatively safe and effective salvage option for rT1 glottic cancer. However, because of its high local recurrence rate, TLM may not be generally recommended for rT2 glottic cancer.