Endoscopic Laser Surgery Effective for Glottic Cancer Recurrence
According to the results of a study conducted in Italy and published in the Archives of Otolaryngology – Head & Neck Surgery, selected patients with glottic cancer recurrence after radiation therapy can be safely and effectively treated with endoscopic carbon dioxide laser surgery.
The glottis is the middle part of the larynx where the vocal cords are located. Early-stage glottic cancer may be treated with radiation therapy or surgery.
Recurrent glottic cancer refers to glottic cancer that has returned following treatment. When glottic cancer recurs locally (in the area of the initial cancer) after radiation therapy, treatment of the recurrence often involves surgery.
Endoscopic laser surgery is a minimally invasive technique in which a scope is passed through the mouth and into the throat, and a laser is used to remove the cancer.
To assess endoscope laser treatment of glottic cancer recurrence, researchers in Italy conducted a study among 37 patients whose initial glottic cancer had been treated with radiation therapy. The study was restricted to patients with recurrences that were confined to the vocal cords or who had less than 5 mm of extension into the supraglottis or subglottis.
- Five-year recurrence-free survival was 58%. The relatively high recurrence rate could have been due to understaging (underestimation of the extent of disease prior to treatment). The researchers note that they now perform computed tomography (CT) of the larynx before surgery in order to better identify patients who are not good candidates for endoscopic laser treatment.
- Five-year overall survival was good at 86%.
- The larynx was preserved in 70% of patients.
- Laryngeal stenosis (narrowing or constriction of the larynx) was the most common complication of the procedure and developed in three out of four women and one out of 33 men.
The researchers conclude that for selected patients with glottic cancer recurrence after radiation therapy, endoscopic laser surgery is safe and effective and allows for laryngeal preservation in a high proportion of cases. The researchers note, however, that women may have a high risk of laryngeal stenosis with the procedure.
Reference: Ansarin M, Planicka M, Rotundo S et al. Endoscopic carbon dioxide laser surgery for glottic cancer recurrence after radiotherapy. Archives of Otolaryngology – Head & Neck Surgery. 2007;133:1193-1197.