Aim of this study was to retrospectively analyze oncologic and functional results of a cohort of T2 and selected T3 glottic tumors treated by transoral laser surgery (TLS). Eighty-nine patients affected by T2 and T3 glottic tumors were treated by TLS from 2005 to 2010 at an academic institution by Type V cordectomies using an "en bloc" or, more frequently, a "piece-meal" technique depending on a number of variables. Kaplan-Meier curves were used to evaluate 5-year overall, disease-specific survivals, local control with laser, and organ preservation rates. Univariate analysis of the impact of different variables was performed. At least 1 year after surgery, we examined: subjective voice evaluation by voice handicap index (VHI), perceptive analysis by GRBAS scale, objective measurements with multidimensional voice program (MDVP), swallowing assessment with the M.D. Anderson Dysphagia Inventory (MDADI), videonasal endoscopic evaluation of swallowing (VEES), and videofluoroscopy (VFS). Fifty-nine patients were pT2 and 30 pT3. The 5-year overall, disease-specific survivals, local control with laser, and organ preservation rates were 92.4, 98.7, 68.5, and 82.1 %, respectively. VHI mean score was 20 (mild dysphonia). Mild and moderate dysphonias were detected by GRBAS in 82 and 18 % of patients, respectively. Mean values of Jitter, Shimmer, and noise-to-harmonic ratio by MDVP resulted 7.87 %, 24.8 %, and 0.37, respectively. Mean value of MDADI was 95.75. Only 2 % of patients at VEES and 4 % at VFS showed tracheal aspiration. Our results highlight that T2 and selected T3 glottic tumors treated by TLS have favorable oncologic and functional outcomes.

Function preservation using transoral laser surgery for T2-T3 glottic cancer : oncologic, vocal, and swallowing outcomes / G. Peretti, C. Piazza, F.D. Bon, R. Mora, P. Grazioli, D. Barbieri, S. Mangili, P. Nicolai. - In: EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY. - ISSN 0937-4477. - 270:8(2013), pp. 2275-2281. [10.1007/s00405-013-2461-9]

Function preservation using transoral laser surgery for T2-T3 glottic cancer : oncologic, vocal, and swallowing outcomes

C. Piazza
;
2013

Abstract

Aim of this study was to retrospectively analyze oncologic and functional results of a cohort of T2 and selected T3 glottic tumors treated by transoral laser surgery (TLS). Eighty-nine patients affected by T2 and T3 glottic tumors were treated by TLS from 2005 to 2010 at an academic institution by Type V cordectomies using an "en bloc" or, more frequently, a "piece-meal" technique depending on a number of variables. Kaplan-Meier curves were used to evaluate 5-year overall, disease-specific survivals, local control with laser, and organ preservation rates. Univariate analysis of the impact of different variables was performed. At least 1 year after surgery, we examined: subjective voice evaluation by voice handicap index (VHI), perceptive analysis by GRBAS scale, objective measurements with multidimensional voice program (MDVP), swallowing assessment with the M.D. Anderson Dysphagia Inventory (MDADI), videonasal endoscopic evaluation of swallowing (VEES), and videofluoroscopy (VFS). Fifty-nine patients were pT2 and 30 pT3. The 5-year overall, disease-specific survivals, local control with laser, and organ preservation rates were 92.4, 98.7, 68.5, and 82.1 %, respectively. VHI mean score was 20 (mild dysphonia). Mild and moderate dysphonias were detected by GRBAS in 82 and 18 % of patients, respectively. Mean values of Jitter, Shimmer, and noise-to-harmonic ratio by MDVP resulted 7.87 %, 24.8 %, and 0.37, respectively. Mean value of MDADI was 95.75. Only 2 % of patients at VEES and 4 % at VFS showed tracheal aspiration. Our results highlight that T2 and selected T3 glottic tumors treated by TLS have favorable oncologic and functional outcomes.
Functional outcomes; Glottic cancer; Laryngeal cancer; Oncologic outcomes; Organ preservation; Swallowing; Transoral laser surgery; Voice; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Deglutition Disorders; Dysphonia; Female; Follow-Up Studies; Glottis; Humans; Kaplan-Meier Estimate; Laryngeal Neoplasms; Laser Therapy; Male; Middle Aged; Neoplasm Staging; Postoperative Complications; Retrospective Studies; Treatment Outcome; Neoplasm Recurrence, Local; Otorhinolaryngology; 2734; Pathology and Forensic Medicine
Settore MED/31 - Otorinolaringoiatria
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/649050
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