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Transoral laser microsurgery for T3 laryngeal tumors: Prognostic factors
Author(s) -
Vilaseca Isabel,
BernalSprekelsen Manuel,
Luis Blanch José
Publication year - 2010
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21288
Subject(s) - medicine , laryngectomy , arytenoid cartilage , transoral laser microsurgery , microsurgery , glottis , surgery , thyroid cartilage , confidence interval , survival rate , overall survival , laryngeal neoplasm , larynx
Background. The objective of this study was to evaluate the outcomes of transoral laser microsurgery (TLM) in T3 laryngeal carcinomas and to identify prognostic factors for survival and laryngeal preservation.Methods. This study aimed to provide a retrospective analysis of 147 consecutive patients, evaluating their overall survival, disease‐specific survival, laryngectomy‐free survival, and function preservation rate.Results. Five‐year overall, disease‐specific, and laryngectomy‐free survivals were 53.1%, 70.2%, and 62.3%, respectively. Disease‐specific survival differed between glottic and supraglottic tumors (86.3% vs 61.8%; p = .015). Function preservation was 65.5% in supraglottic and 49.1% in glottic tumors ( p = .002). Disease‐specific survival was not related to pre‐epiglottic involvement, cord fixation, or focal cartilage infiltration ( p > .05). Vocal cord fixation and cartilage infiltration were independent negative prognostic factors for organ preservation (odds ratio [OR] = 0.184; 95% confidence interval [CI] = 0.082–0.411; p = .000 and OR = 0.331; 95% CI = 0.139–0.789; p = .013, respectively).Conclusion. Our conclusion is that TLM is a good alternative in a large number of T3 laryngeal tumors, with adequate survival and organ preservation rates above 60%. © 2009 Wiley Periodicals, Inc. Head Neck, 2010