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  • Title: Salvage transoral laser microsurgery for early recurrent glottic carcinoma after primary laser treatment.
    Author: Huang J, Yu Z, Fang J, Chen X, Chen X, Huang Z.
    Journal: Acta Otolaryngol; 2013 May; 133(5):531-7. PubMed ID: 23350599.
    Abstract:
    CONCLUSION: Salvage transoral laser microsurgery (TLM) may be a curative organ-preserving treatment for early recurrent glottic carcinoma after primary laser resection. However, failure after TLM seems to be associated with decrease of survival and larynx preservation rates. OBJECTIVE: To evaluate the oncological results of salvage TLM for early recurrent glottic carcinoma after primary laser treatment. METHODS: Records of 50 patients with local recurrences of glottic carcinoma treated by salvage TLM between January 1994 and December 2008 were retrospectively analyzed. RESULTS: Thirty-six rT1 and 14 rT2 lesions were treated with salvage TLM. Mean follow-up was 68.3 months. Thirty-one patients were cured by first salvage TLM and four by further laser procedures. The other 15 patients were finally salvaged by laryngectomy or radiotherapy. Five-year overall survival, disease-specific survival, local control, and loco-regional control rates were 89.9%, 97.9%, 62.3%, and 60.1%, respectively. Larynx preservation rate after long-term follow-up was 86%. In univariate analysis, second local recurrence showed a statistically significant impact on disease-specific survival rate ( p = 0.049) and larynx preservation rate ( p = 0.006). In multivariate analysis, it was associated with a statistically significant decrease in larynx preservation rate ( p = 0.016). There was no statistically significant difference in oncological results between patients with and without anterior commissure involvement.
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