Artikel
Endoscopic CO2 laser treatment in supraglottic carcinoma – late oncological outcomes
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Veröffentlicht: | 4. April 2012 |
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Gliederung
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Introduction: This study presents the indications, contraindications, limits and results of the treatment of laryngeal supraglottic carcinoma endoscopical with CO2 Laser and with classical open surgery.
Material and Methods: Between 1996 and 2010 were treated 52 patients. Between 1996 and 2005, in 27 patients (51,92%) (staged I and II, N0) we performed endoscopic CO2 Laser surgery with postoperative XRT on the cervical lymph nodes. In 8 cases (29,62%) we performed simple epiglottectomy, in 12 cases (44,44%) extended epiglottectomy and in 7 cases (25,92%) endoscopic HSL. 8 patients (29,62%) were staged I and 19 patients (70,37%) stage II. Between 1996 and 2010 we performed in 25 cases (48,07%) classic open HSL with bilateral selective neck dissection. 2 patients (8%) were in stage I, 12 patients (48%) in stage II and 11 patients (44%) in stage III (T2N1M0). Postoperative follow-up was between 12-48 month, average 36 month.
Results: We obtained the following oncological results in the group of endoscopic treatment: no evidence of disease (NED) – 22 cases [(81,48%) 8 patients in stage I and 14 patients in stage II] and local recurrences in 5 cases (18,51%, stage II). The functional results were good and very good in all cases. In the group of classic surgery the oncologic results were as follow: NED – 19 cases (76%) and local recurrences in 6 cases (24%) (2 patients (8%) in stage II and 4 patients (16%) in stage III T2N1M0). Total laryngectomy with or without neck dissection and adjuvant XRT was the recurrences therapeutic alternatives.
Conclusion: Endosocopic CO2 laser microsurgery appears to be an effective and safe alternative treatment for T1-T2N0 supraglottic carcinoma, with the same oncologic results and functional results superior than the other techniques.