Abstract
T1–T2 glottic carcinomas may be treated with conservative surgery or radiotherapy. The goals of treatment are cure and laryngeal voice preservation. The aim of the current study was to review the literature and discuss the optimal management of T1 and T2 glottic carcinoma. Literature review indicated that the local control, laryngeal preservation, and survival rates of patients were similar after transoral laser resection and open partial laryngectomy. Voice quality depended on the extent of resection for patients undergoing surgery; results for patients undergoing laser resection for limited lesions showed better Voice Handicap Index scores, whereas open partial laryngectomy yielded poorer results. The cost of treatment was more for open partial laryngectomy. Patients with well defined lesions suitable for transoral laser excision with a good functional outcome were treated with laser. Open partial laryngectomy was reserved for patients with locally recurrent tumors. This review has been conducted by analyzing the Data which has been displayed in Pubmed literature in the last 25 years on the topics of Transoral Laser and Open partial Laryngectomy in the management of T1 and T2 glottic cancer. The various original articles and review articles were analyzed and compared and a conclusion derived.
Highlights
In India, at 30-69 years, the three most common fatal cancers were oral, stomach (25,200 12·6%), and lung in men
For advanced cases, chemotherapybased protocols have been validated, but the best protocol is still to be defined.[2]. In this present review of literature we have considered carcinoma in situ (Tis), nonmetastasizing tumours involving one (T1a) or both (T1b) vocal cords as well as unilateral or bilateral glottic carcinomas with infiltration of the supra- and/or subglottis with or without preservation of vocal cord mobility (T2)
Management of T1 and T2 Glottic cancer Management of patients with T1 – T2 N0 disease may vary from transoral laser excision, open partial laryngectomy and chemoradiotherapy but the goals of treatment are cure and laryngeal voice preservation
Summary
In India, at 30-69 years, the three most common fatal cancers were oral (including lip and pharynx, 45,800 22·9%), stomach (25,200 12·6%), and lung (including trachea and larynx, 22,900 11·4%) in men. Open surgery, transoral laser or irradiation may control the disease and preserve the larynx function. 2. Management of T1 and T2 Glottic cancer Management of patients with T1 – T2 N0 disease may vary from transoral laser excision, open partial laryngectomy and chemoradiotherapy but the goals of treatment are cure and laryngeal voice preservation. It is seen that in more than 95% of patients who have disease recurrences will do so within 5 years of treatment, so outcomes reported at 5 years accurately reflect the efficacy of therapy.[3] Endpoints of interest include local control, ultimate local control (including successful salvage treatment after a local tumour recurrence), absolute survival, cause-specific survival, and complications. 4 Cost is important and varies depending on the methods of reimbursement Data pertaining to this endpoint are even more limited. Data pertaining to this endpoint are even more limited. 2.1 Local Control 2.1.1 Transoral laser excision (Table 1): In transoral laser excision, the lesions are removed with a clear margin of approximately 1–3 mm
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