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  • Title: Transoral laser microsurgery for recurrent laryngeal and pharyngeal cancer.
    Author: Grant DG, Salassa JR, Hinni ML, Pearson BW, Hayden RE, Perry WC.
    Journal: Otolaryngol Head Neck Surg; 2008 May; 138(5):606-13. PubMed ID: 18439466.
    Abstract:
    STUDY DESIGN AND SETTING: A two-center prospective case series analysis. PATIENTS: One hundred fourteen patients with previously treated laryngeal or pharyngeal squamous cell carcinoma who underwent salvage transoral laser microsurgery (TLM). INTERVENTIONS: TLM in 114 patients, neck dissection in 22 (19%) patients, adjuvant radiotherapy in 12 (11%) patients. RESULTS: Ninety-one (80%) patients had recurrent primary tumors whereas 23 (20%) patients had second primary tumors occur within a previously irradiated field. The minimum follow-up was 1 year (median, 3 years). The distribution of tumor location was oropharynx 52 (46%), glottic and subglottic larynx 44 (39%), supraglottic larynx 11 (10%), and pyriform/hypopharynx 7 (6%). Overall, three-year local and locoregional control estimates were 70 percent and 67 percent, respectively; and three-year survival and disease-free survival estimates were 62 percent and 64 percent, respectively. The average duration of hospitalization was 2.3 days. Four (3.5%) patients had significant postoperative bleeding. Two (<2%) patients had treatment-related deaths. CONCLUSIONS: Transoral laser microsurgery offers select patients an attractive alternative salvage surgical therapy to the recurrent and second primary tumor site.
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