Relationship between local recurrence and anterior commissure involvement after CO2 laser endoscopic resection

Abstract

Objective:This work aims to analyze the relationship between local recurrence and location of the tumor in early glottic carcinoma after CO_2 laser endoscopic resection.Methods:Data of 133 early glottic carcinoma cases,which were treated with laser surgery and were hospitalized at the cancer center of Sun Yan-Sen University from 2008 to 2010,were reviewed retrospectively.Of the 133 cases,48 involved the anterior commissure and the other 85 did not.Of the total cases,Tis stage lesion(tumor in situ) was found in 58 cases,T_(1a) stage in 58,T_(1b) stage in 19,T_2 stage in 15,and T_3 stage in only 1.The follow-up period ranged from 6 to 42 months.The local recurrence rate between the involvement and non-involvement of anterior commissure was compared.Results:Local recurrence was detected in 21 of the 133 cases with early glottic laryngeal carcinoma after CO_2 laser surgery.The local recurrence rate was 15.79% (21/133).The recurrence rates of T_(1a),T_(1b),T_2,and T_3 were 8.62%,36.84%,13.33%,and 0%,respectively.No significant difference was found among the four groups(P≥0.05).Among the 135 patients presenting with early glottic cancer,the anterior commissure was involved in 48 cases,with a local recurrence rate of 25%(12/48).In 85 of the cases without anterior commissure involvement,the local recurrence rate was 10.59%(9/85).Significant differences were found between the two groups(P≤0.05).Of the 133 patients who received CO_2 laser surgery as the only therapy,129 survived and 4 died.Conclusion:After laser microsurgery of early glottic carcinoma, a higher rate of tumor recurrence was found in the lesions with anterior commissure involvement.This finding needs further research.