Positive Histopathological Margins: Are They Always Associated with Tumor Recurrence in Early Glottic Carcinoma?

Abstract

Introduction: Squamous cell carcinoma of the larynx is one of the most common neoplasms in the head and neck region. In its early stages, it is characterized by a favorable oncological prognosis, leading to a management approach that focuses not only on the oncological aspect but also on the preservation of laryngeal functions. Transoral microsurgery with CO2laser (TML) demonstrates comparable effectiveness rates to open surgery and radiotherapy, and offers several advantages when compared to other treatment modalities. Objective: The aim of this study was to review the oncological outcomes achieved through the treatment of a series of early glottic tumors using TML in a tertiary university hospital. Methods: A retrospective review of medical records was conducted for patients diagnosed with early-stage squamous cell carcinoma of the larynx who underwent TML at a tertiary-level hospital between January 2012 and December 2019. Results: A total of 48 patients met the inclusion criteria: 91.7% males and 8.3% females. The mean age at diagnosis was 64.4 ± 13.3 years (min.: 36 / max.: 88). Among these, 83.3% had a history of smoking. The rate of organ preservation or laryngeal survival was 93.7%. Of the patients who did not experience tumor recurrence, 83% exhibited positive surgical margins. Conclusions: TML represents a therapeutic alternative for early-stage laryngeal tumors. Careful analysis of surgical margins is crucial, and close follow-up is recommended for all patients.

Keywords

• laryngeal neoplasms
• laryngoscopy
• larynx microsurgery
• neoplasms surgery