Transoral Laser Microsurgery vs Radiotherapy for Early Glottic Cancer: Study at Tertiary Care Center in India

Abstract

ABSTRACT Aim To compare laryngeal preservation rates, survival rates, and voice outcomes after treatment of early glottic cancer between transoral laser microsurgery (TLM) and radiotherapy (RT). Materials and methods A review of oncologic results was performed on a consecutive series of individuals with early-stage glottic carcinoma (T1 and T2) who were treated between 2011 and 2014 at Kidwai Memorial Institute of Oncology and had received either RT or TLM. Data were collected with a view to assess overall survival, disease-specific survival, laryngectomyfree survival, and laryngeal preservation rates. The Voice Handicap Index-30 (VHI-30) was used as the measure of voice quality after treatment. Results Two-year overall survival for TLM group was 93.8% and for RT group was 90.5%, p = 0.643. Disease-free survival (TLM = 90.6% vs RT = 76.2%) was not found to be significant (p-value = 0.104). Laryngeal preservation rate was 79.5% in TLM and 71.4% in RT group (p-value = 0.003). Laryngectomy- free survival was better in TLM (TLM = 96.9% vs RT = 76.2%, p = 0.003). Substage analysis showed equivalent voice for TLM (VHI = 6–12) and RT (VHI = 6–14) in T1a patients (p = 0.94), whereas voice outcome was better for RT in T1b (VHI = 10–16 for TLM vs VHI = 11–18 for RT, p = 0.044) and T2 (VHI = 21–29 for TLM vs VHI = 16–23 for RT, p = 0.002) stages. Conclusion Transoral laser microsurgery can be considered the treatment of choice for early glottic cancer in view of better laryngeal preservation rate and laryngectomy-free survival with added advantage of low treatment cost and shorter hospital stay compared with RT. Clinical significance Laryngeal cancers represent the most common malignancy of head and neck, with estimated worldwide incidence of 120,000 cases annually. Optimal treatment modality has generated significant controversy in literature. External beam RT, open partial laryngectomy, and TLM are various treatment options available. This study depicts TLM as a preferred modality for early glottic cancer. How to cite this article Shenoy AM, Sharma V, Chavan P, Halkud R, Ranganath N, Pasha T, Shenoy P, Ravikumar B, Narayana SM, Sharif MI, Vijay CR. Transoral Laser Microsurgery vs Radiotherapy for Early Glottic Cancer: Study at Tertiary Care Center in India. Int J Head Neck Surg 2017;8(1):15-20.