TY - JOUR
T1 - Functional and oncological outcomes of primary versus salvage transoral laser microsurgery for supraglottic carcinoma
AU - Hutcheson, Katherine A.
AU - Jantharapattana, Kitti
AU - Barringer, Denise A.
AU - Lewin, Jan S.
AU - Holsinger, F. Christopher
N1 - Funding Information:
From the Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas. Drs Hutcheson and Jantharapattana contributed equally to this work. Dr Hutcheson acknowledges funding from The University of Texas Health Innovation for Cancer Prevention Research Fellowship, The University of Texas School of Public Health–Cancer Prevention and Research Institute of Texas (CPRIT) grant RP101503. The content is solely the responsibility of the authors and does not necessarily represent the official views of the CPRIT.
PY - 2012/10
Y1 - 2012/10
N2 - Objectives: We evaluated the functional and oncological outcomes of transoral laser microsurgery (TLM) in patients with previously untreated supraglottic carcinoma compared with the outcomes in salvage cases after radiation-based treatment. Methods: We conducted a retrospective case-control study at a single academic tertiary care institution. The functional outcomes were stratified by prior irradiation and were assessed at baseline, less than 1 week after operation, and at last follow-up. Results: Five patients underwent TLM for previously untreated disease, and 5 previously irradiated patients underwent salvage TLM for local failure. No patient required tracheostomy. There was no local recurrence after TLM as primary therapy, and none of those patients required radiotherapy. One salvage patient developed local recurrence. The duration of feeding tube dependence (p = 0.049) and the rates of chronic aspiration (more than 1 month after operation; p = 0.048) were significantly higher in the salvage TLM cases than in the previously untreated cases. The median scores on the PSSHN Understandability of Speech were 75 ("usually understandable") in the salvage group and 100 ("always understandable") in the previously untreated group. Conclusions: Both local control and function were better in the previously untreated patients than in the salvage patients. Our findings provide support for the use of TLM as a primary treatment modality for selected supraglottic carcinomas, but also suggest a potential for functional recovery in both previously untreated and salvage cases.
AB - Objectives: We evaluated the functional and oncological outcomes of transoral laser microsurgery (TLM) in patients with previously untreated supraglottic carcinoma compared with the outcomes in salvage cases after radiation-based treatment. Methods: We conducted a retrospective case-control study at a single academic tertiary care institution. The functional outcomes were stratified by prior irradiation and were assessed at baseline, less than 1 week after operation, and at last follow-up. Results: Five patients underwent TLM for previously untreated disease, and 5 previously irradiated patients underwent salvage TLM for local failure. No patient required tracheostomy. There was no local recurrence after TLM as primary therapy, and none of those patients required radiotherapy. One salvage patient developed local recurrence. The duration of feeding tube dependence (p = 0.049) and the rates of chronic aspiration (more than 1 month after operation; p = 0.048) were significantly higher in the salvage TLM cases than in the previously untreated cases. The median scores on the PSSHN Understandability of Speech were 75 ("usually understandable") in the salvage group and 100 ("always understandable") in the previously untreated group. Conclusions: Both local control and function were better in the previously untreated patients than in the salvage patients. Our findings provide support for the use of TLM as a primary treatment modality for selected supraglottic carcinomas, but also suggest a potential for functional recovery in both previously untreated and salvage cases.
KW - Supraglottic carcinoma
KW - Swallowing
KW - Transoral laser microsurgery
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U2 - 10.1177/000348941212101007
DO - 10.1177/000348941212101007
M3 - Article
C2 - 23130541
AN - SCOPUS:84867669749
SN - 0003-4894
VL - 121
SP - 664
EP - 670
JO - Annals of Otology, Rhinology and Laryngology
JF - Annals of Otology, Rhinology and Laryngology
IS - 10
ER -