gms | German Medical Science

Introduction: Transoral CO2 laser surgery (1987-2011) of early (T1, T2) laryngeal cancer is demontrated focusing on oncological results, quality of life, complications and cost benefit aspects.

Material and methods: 438 endoscopic laser surgeries of early laryngeal cancer (375 laser cordectomies and 63 supraglottic resections) were analysed. Patients underwent endoscopy, CT, (MRI) and quality of life study as voice analysis, aspiration, social life (The Euro QoL Group 2014 and questionnaire) and cost benefit aspects comparing with open access surgery.

Results: After a single laser cordectomy 87.5% of the patients is tumour free, but after salvage treatments 97%. In the supraglottic group 47 patients are free of tumour after primary laser resection (75%). Survival after salvage therapy is 98%.

Analysis of voice quality of glottic cancer revealed an acceptable-good voice in type I_II. laser cordectomies and no significant change in supraglottic cases. Transoral laser surgery resulted in a significantly less aspiration and complications than external approach method, also avoiding tracheostomy. Hospitalization after endoscopic surgery patients is 1-8 days versus 10-30 days of external approach surgery.

Conclusions: Transoral CO2 laser surgery of the early laryngeal cancer proved to be a primary treatment option with good oncological results, better peri- and postoperative quality of life and benefits on costs.

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