gms | German Medical Science

Objectives/hypothesis: This study aimed to evaluate the oncologic results of endoscopic and open surgical techniques in treating T2 glottic carcinomas.

Study design: Retrospective clinical study.

Methods: The files of 354 T2 glottis cancer cases managed with primary surgery were reviewed. Transoral laser microsurgery and frontolateral partial laryngectomy were compared for disease-specific survival and local control rates, incidence of major complications and related tracheostomies in all the study patients and in only that group of patients with involvement of the anterior commissure. Additionally, the influence of invasion of the anterior commissure on these oncologic parameters was evaluated.

Results: No statistically significant differences were found between the surgical procedures regarding disease-specific survival and local control in all the study patients and in only those patients with anterior commissure involvement. A lower incidence of complications and a significantly lower incidence of tracheostomy were found for laser surgery compared with the open technique. Tumor invasion of the anterior commissure did not seem to influence the oncologic results.

Conclusions: Transoral surgery seems to be the treatment of choice for T2 glottic cancer, even for patients with invasion of the anterior commissure, offering a sound oncologic outcome, favorable functional results, a lower rate of tracheostomy in comparison with the open procedures, and the not-insignificant possibility for repeated resection when needed. In our view, open partial laryngectomy should be reserved for those cases of T2 glottic tumors where the lesion cannot be adequately exposed by direct microlaryngoscopy.