Article
Impact of imaging on transoral CO2 laser-resection of early laryngeal cancer
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Published: | March 26, 2015 |
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Introduction: Authors report transoral CO2 laser surgery of early laryngeal cancer focusing on imaging preoparatively and in the follow up detecting local recurrences and regional metastasis
Material and methods: 375 laser cordectomies were performed in T1-T2 vocal cord tumours and 63 patients with T1, T2 supraglottic tumour underwent transoral supraglottic laser resection. 10 supraglottic tumours got primary neck dissection.
Preoperative CT, MRI was performed in order to evaluate the infiltration of the thyroid and arytenoid cartilage, preepiglottic space and detecting neck metastasis for the indication of transoral laser surgery or external approach surgery and neck management.
Recurrences underwent imaging assessment to make decision on salvage treatment.
Results: After a single laser cordectomy 87.5% of the patients is tumour free. Local recurrence were treated with repeated laser resection (15), 6 partial resections of the larynx, 6 radiation therapies and 9 laryngectomies. In the supraglottic group 47 patients are free of tumour after primary laser excision. 16 patients with local recurrence underwent salvage treatments: 7 repeated laser laser resections, 3 radiation therapies 4 supraglottic laryngectomies and 2 laryngectomies. Late neck metastasis developed in 5 patients, that required radical neck dissections. Tumor free survical is 75%. Survival after salvage therapy is 98%.
Conclusions: Transoral CO2 laser surgery of the early laryngeal cancer proved to be a primary treatment option with good results. Imaging (CT, HRCT, MRI) has high significance in evaluation of tumour spreading and metastasis formation especially in supraglottic cases planing salvage treatments for recurrences.
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