gms | German Medical Science

Objectives: Twenty years of experiences with 332 endoscopic-microscopic laser-cordectomy on 289 patients for early glottic carcinoma. Familiarization with the practicability of this surgery in relation to the stages of vocal cord lesions resulted in subgroups i.e. “superficial”, “partial”, “total” and “extended” cordectomy which was adapted by the E. L. S. (2000).

Methods: The present study is based on a retrospective clinical-pathological analysis of "en bloc" resected glottic specimens and patient's charts obtained from 232 patients having vocal cord carcinoma treated by endoscopic-microscopic laser surgery.

Results: For minimum 3-year follow-up (May 1987–March 2004), the endoscopic CO₂-laser surgery alone controlled the early vocal cord carcinoma in 87%, 13% required salvage therapy. After ”laser-salvage”, the local control rate was mounted to 93%, and with the conventional salvage therapy finally resulted in 97 %. The organ preservation’s rate achieved 96%, and 8 patients had lost their larynges.

Voice quality became worse in the postoperative period, but improved later significantly.

Conclusions: Based on 20 years of experience with laser-cordectomy, the excellent re-treatment options in case of local failure and these favorable oncological results, endoscopic minimally invasive laser cordectomy should be the first choice of treatment for early glottic cancer.

Radiotherapy and open partial laryngectomy should be reserved for salvage therapy.