gms | German Medical Science

Introduction: For early stage laryngeal carcinoma transoral laser surgery (TLS) has replaced the open partial laryngectomy (OPL) as the primarily performed surgical procedure. This study reflects our 15 year experience focussing on the oncological outcome after TLS and OPL for early stage laryngeal carcinoma.

Methods: This retrospective case-series evaluates the oncological results after TLS or OPL of all patients presenting to our ENT-Department with an T1-T3 glottic or supraglottic laryngeal carcinoma between 1992-2002.

Results: 94 patients with previously untreated laryngeal carcinomas were included, 77 glottic carcinomas (T1-T2) and 17 supraglottic carcinomas (T1-T3). Patients were followed up for a mean of 61 months. Sixty-five carcinomas were treated with TLS including 49 glottic and 16 supraglottic carcinomas. OPL was performed in 28 glottic carcinomas and one T2 supraglottic tumor. Supraglottic tumors (T1-T3) showed no recurrence regardless of the initial tumor stage or surgical procedure during follow up. In glottic carcinomas (T1-T2), local tumor control was 90% after OPL and 80% following TLS with initial treatment. In case of tumor spread to the anterior commissure recurrence rates raised to 13% after OPL and 38% following TLS.

Conclusion: Both transoral laser surgery and open partial laryngectomy are highly effective treatment options for early stage glottic and supraglottic carcinomas. In case of tumor extension to the anterior commissure TLS yielded poorer results compared to open partial laryngectomy. Therefore, open partial laryngectomy is to be recommended as an appropriate and oncologically feasible surgical procedure in early stage carcinomas with a particular emphasize in cases of glottic carcinomas infiltrating the anterior commissure.