Role of margin status in recurrence after CO2 laser endoscopic resection of early glottic cancer.

CONCLUSION: In patients with early glottic squamous cell carcinoma (SCC) submitted to CO2 laser endoscopic resection, local disease recurrence was significantly correlated with the presence of positive additional surgical margins on permanent sections.

OBJECTIVES: To evaluate the rate of cancer recurrence in patients with early glottic SCC submitted to CO2 laser endoscopic resection according to margin status after resection, stage of disease and postoperative radiotherapy. The rate of larynx preservation and the length of hospital stay were also evaluated.

MATERIAL AND METHODS: Forty consecutive patients with early glottic cancer were subjected to laser endoscopic resection surgery of glottic cancer followed by frozen-section control of margins, with intraoperative enlargement of margins when positive. Adjuvant radiation therapy or enlargement of previous margins was indicated in the case of positive additional surgical margins on permanent section.

RESULTS: Local recurrence occurred in three patients (7.5%), all with positive additional surgical margins on permanent section. Positive additional surgical margins on permanent section were related to 37.5% of recurrences and negative additional surgical margins with 0% of recurrences (p=0.006). All patients spent at most 1 day at the hospital.