The present authors' treatment approach for the comprehensive management of early glottic cancer (Tis-T2) can be categorized into two basic therapeutic scenarios. Tis and T1a lesions of the midcord are treated preferably by an EB, which, after appropriate pre- and intraoperative diagnostic work-up, including at least VLS, SI into the Reinke's space, and rigid endoscopy, allows the achievement, in a single procedure, of a precise diagnosis and definitive treatment of the lesion. Postoperative voice quality has been shown to be comparable to that of controls. Moreover, this approach is associated with minimal morbidity, short hospitalization time, and a high cost-effectiveness ratio. On the other hand, T1b and T2 tumors deserve special attention because comparable oncologic outcomes can be achieved with other surgical and nonsurgical therapeutic modalities. Therefore, the appropriate preoperative counseling, including other voice-sparing options (eg, radiation or chemoradiation therapy), should be always discussed with the patient. Great caution should be also observed with T2 lesions in which there is impaired vocal cord mobility because of the possibility of invasion through the vocal muscle into the paraglottic space (T3). In such cases, frustrating results have been obtained in the present authors' series by endoscopic surgery alone, and further complementary treatment modalities should always be considered.

Endoscopic treatment for early glottic cancer : indications and oncologic outcome / G. Peretti, C. Piazza, A. Bolzoni. - In: OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA. - ISSN 0030-6665. - 39:1(2006), pp. 173-189.

Endoscopic treatment for early glottic cancer : indications and oncologic outcome

C. Piazza;
2006

Abstract

The present authors' treatment approach for the comprehensive management of early glottic cancer (Tis-T2) can be categorized into two basic therapeutic scenarios. Tis and T1a lesions of the midcord are treated preferably by an EB, which, after appropriate pre- and intraoperative diagnostic work-up, including at least VLS, SI into the Reinke's space, and rigid endoscopy, allows the achievement, in a single procedure, of a precise diagnosis and definitive treatment of the lesion. Postoperative voice quality has been shown to be comparable to that of controls. Moreover, this approach is associated with minimal morbidity, short hospitalization time, and a high cost-effectiveness ratio. On the other hand, T1b and T2 tumors deserve special attention because comparable oncologic outcomes can be achieved with other surgical and nonsurgical therapeutic modalities. Therefore, the appropriate preoperative counseling, including other voice-sparing options (eg, radiation or chemoradiation therapy), should be always discussed with the patient. Great caution should be also observed with T2 lesions in which there is impaired vocal cord mobility because of the possibility of invasion through the vocal muscle into the paraglottic space (T3). In such cases, frustrating results have been obtained in the present authors' series by endoscopic surgery alone, and further complementary treatment modalities should always be considered.
Biopsy; Glottis; Humans; Laryngeal Neoplasms; Laryngectomy; Predictive Value of Tests; Treatment Outcome; Vocal Cords; Laryngoscopy; Otorhinolaryngology; 2734; Pathology and Forensic Medicine
Settore MED/31 - Otorinolaringoiatria
2006
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/649038
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