Partial surgical treatment in early glottic cancers

Abstract

Objectives:We evaluated the partial surgical management and survival rates in patients who were treated for early glottic cancers.Methods:A retrospective study of therapeutic outcomes was performed on 48 patients with Tis-T1-T2/N0 cancers of the glottic laryngeal carcinoma, treated by partial surgery, from 1998 to 2004. Surgical techniques were employed in view of factors such as involvement of anterior commissure and tumor stages. Decannulation time, swallowing time, survival rates, complications and outcomes were evaluated.Results:Four patients (8.3%) with Tis, 25 (52.1%) with T1a, 9 (18.8%) with T1b, 10 (%20.8) with T2 tumors were followed up. Surgical techniques were included stripping (n=4, 8.3%), cordectomy (n=14, 29.4%), horizontal glottectomy (n=1, 2.1%), vertical partial laryngectomy (n=10,20.8%), frontolateral partial laryngectomy (n=17, 35.4%), supracricoid partial laryngectomy (n=2; 4.2%). Postoperatively positive surgical margin was reported in 5 (10.4%) patients. Three of 5 patients with positive margins developed recurrences. These patients were treated with postoperative radiotherapy. One patient without positive margins developed regional recurrence, treated by unilateral neck dissection and postoperative radiotherapy. The 3-year overall survivals were 96.9% for T1, 90.5% for Tis, T1 and T2.Conclusion:Surgical treatment provides excellent local control and laryngeal preservation in early glottic cancers. The choice of treatment should be patient spesific and based on a careful analysis of the factors involved in each case.

Keywords

• carcinoma
• glottis
• laryngectomy
• recurrence
• survey.