Endolaryngeal cordectomy using cold instruments for treatment of T1 glottic cancers

Abstract

In the treatment of early-stage glottic cancers, radiotherapy and surgery have similar success rates. In our department, we have been using cold instruments coupled with surgical microscope and/or telescopes for several years in treatment of early stage glottic cancers. Our aims were, to present our experience with endolaryngeal resection of T1 glottic cancers with cold instruments coupled with surgical microscope and telescopes, to present our oncological results, to discuss the advantages of endolaryngeal cordectomy over open cordectomy or RT and to discuss whether laser is obligatory for this approach or not. Our study includes retrospective analysis of 38 patients with T1 glottic cancer, who have been treated with endolaryngeal surgery as the primary treatment. The median follow-up was 24 months. The most commonly performed procedure was type-II cordectomy (38.5%). Overall survival rate was 94.7%, while the disease-specific survival rate was 100%. Local recurrences occurred in two patients at 8th and 11th months, postoperatively. In the first patient, type-Vc cordectomy and in the second type-Va cordectomy had been performed. Both patients with recurrences could be salvaged by fronto-lateral laryngectomy, and are still alive in their 38th and 6th months following salvage surgery. Therefore, the local control rate and larynx preservation rate with endolaryngeal cordectomy were 94.7 and 100%, respectively, in this study group. All patients had a voice quality sufficient for communicating easily over telephone. We believe that lasers are not obligatory to perform endolaryngeal cordectomy for treatment of T1 glottic cancers, as the same oncological and similar functional outcomes may be achieved with the traditional cold instruments.