Transoral treatment of stageg T3 laryngeal cancer

Abstract

Objectives: To determine the local control rate and disease-specific survival rate in patients with staged T3 laryngeal cancer treated with electrocautery, radiofrequency or CO2 laser transoral microsurgery as well as the incidence of complications and tracheostomy, gastrostomy or enteral nutrition requirement in these patients. Study design: Descriptive and prospective. Methods: Twenty seven patients with T3 laryngeal cancer were treated with electrocautery, radiofrequency or CO2 laser microsurgery at the Italian Hospital of Buenos Aires between August 2009 and december 2016. Patients with T3 tumors were classified according to the 2002 American Joint Committee on Cancer (AJCC) TNM staging system. These tumors caused vocal cord fixation, pre-epiglottic or paraglottic space involvement, focal infiltration of the thyroid cartilage or postcricoid invasion. Results: The initial local control rate was 44.44% (12/27), local control with rescue treatment was 59.25% (16/27). The specific survival was 59.25% (16/27). The rate of preservation of the larynx was 44.44% (12/27). The average follow-up time was 5 years. Four patients had serious complications: esophageal, glottic and esophageal stenosis (postadjuvant treatment with (QT/RT) and two had postoperative bleeding.Two patients needed a postoperative tracheostomy (7.40%) and 25 were able to feed orally (92.59%). The mortality due to complications was 3.7% (1/27). Conclusion: In patients treated by a transoral approach, for T3 staged laryngeal cancer, the initial local control rate was 44.44% (12/27), and local control with rescue treatment was 59.25% (16/27). The specific survival was 59.25% (16/27), and the rate of preservation of the larynx was 44.44% (12/27). Transoral sugery, in selected patients with T3 staging laryngeal cancer represents other therapeutic option to preserve the function of the larynx and has oncological results similar to other treatments. The use of radiofrequency or cautery to resect the tumor reduces the costs of treatment