Single Stage Transoral Laser Microsurgery for Early Glottic Cancer
Objectives: The purpose of the study was to present the outcome of our management protocol of a single stage transoral laser microsurgery (SSTLM), with the intention of complete removal of a lesion, considered to be an early glottic cancer.Methods: Between January 2015 to February 2017 patients with...
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doaj-b743fb0f78fa4c5d8e661813618e30d22020-11-25T00:07:19ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2018-08-01810.3389/fonc.2018.00298385991Single Stage Transoral Laser Microsurgery for Early Glottic CancerYaniv Hamzany0Yaniv Hamzany1Hagit Shoffel-Havakuk2Hagit Shoffel-Havakuk3Stav Devons-Sberro4Shani Shteinberg5Shani Shteinberg6Dan Yaniv7Dan Yaniv8Aviram Mizrachi9Aviram Mizrachi10Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petach Tikva, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petach Tikva, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelHadassah-Hebrew University School of Medicine, Jerusalem, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelInstitute for Speech, Swallowing and Voice Rehabilitation, Rabin Medical Center, Petach Tikva, IsraelDepartment of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petach Tikva, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelDepartment of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petach Tikva, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelObjectives: The purpose of the study was to present the outcome of our management protocol of a single stage transoral laser microsurgery (SSTLM), with the intention of complete removal of a lesion, considered to be an early glottic cancer.Methods: Between January 2015 to February 2017 patients with the clinical appearance of an early glottic cancer, who were candidates for (SSTLM) management protocol, were included in this study. Type of cordectomy was determined by pre- and intra-operative evaluation of the extent of lesion in cord layers.Results: Thirty patients (6 females, 24 males; mean age 65 years) underwent SSTLM. Twenty-two patients had malignant histopathological diagnosis of severe dysplasia or Cis in 4 patients, microinvasice carcinoma in 3 patients and invasive carcinoma in 15 patients (T1a tumor in 14 and T1b tumor in 1). Eight patients had a nonmalignant histological diagnosis of keratosis without atypia in 2 patients, mild dysplasia in 2 patients and moderate dysplasia in 3 patients. Based on pre- and intra-operative evaluation, 14 subepithelial (type I), 10 subligamental (type II), and 6 transmuscular (type III) cordectomies were performed. Comparison of cordectomies types with postoperative histopathologic diagnosis showed an adequate extent of resection in 26 out of 30 patients (87%). Considering only patients without recent background of direct laryngoscopy and biopsy, an adequate resection was performed in 90% of patients. None of the patients was further treated by external beam radiation. At average follow-up of 21 months, none of the patients developed local recurrence.Conclusion: In selected cases, a SSTLM for clinical appearance of an early glottic cancer, allows a reliable histopathologic diagnosis and a high local control rate with favorable cost effectiveness. A careful pre- and intraoperative evaluation for selecting the appropriate cases for this management is required in order to avoid under- or over-treatment.https://www.frontiersin.org/article/10.3389/fonc.2018.00298/fullglottic cancerCO2 laserexcisional biopsysingle stagetransoral laser microsurgerycomplete removal |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yaniv Hamzany Yaniv Hamzany Hagit Shoffel-Havakuk Hagit Shoffel-Havakuk Stav Devons-Sberro Shani Shteinberg Shani Shteinberg Dan Yaniv Dan Yaniv Aviram Mizrachi Aviram Mizrachi |
spellingShingle |
Yaniv Hamzany Yaniv Hamzany Hagit Shoffel-Havakuk Hagit Shoffel-Havakuk Stav Devons-Sberro Shani Shteinberg Shani Shteinberg Dan Yaniv Dan Yaniv Aviram Mizrachi Aviram Mizrachi Single Stage Transoral Laser Microsurgery for Early Glottic Cancer Frontiers in Oncology glottic cancer CO2 laser excisional biopsy single stage transoral laser microsurgery complete removal |
author_facet |
Yaniv Hamzany Yaniv Hamzany Hagit Shoffel-Havakuk Hagit Shoffel-Havakuk Stav Devons-Sberro Shani Shteinberg Shani Shteinberg Dan Yaniv Dan Yaniv Aviram Mizrachi Aviram Mizrachi |
author_sort |
Yaniv Hamzany |
title |
Single Stage Transoral Laser Microsurgery for Early Glottic Cancer |
title_short |
Single Stage Transoral Laser Microsurgery for Early Glottic Cancer |
title_full |
Single Stage Transoral Laser Microsurgery for Early Glottic Cancer |
title_fullStr |
Single Stage Transoral Laser Microsurgery for Early Glottic Cancer |
title_full_unstemmed |
Single Stage Transoral Laser Microsurgery for Early Glottic Cancer |
title_sort |
single stage transoral laser microsurgery for early glottic cancer |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2018-08-01 |
description |
Objectives: The purpose of the study was to present the outcome of our management protocol of a single stage transoral laser microsurgery (SSTLM), with the intention of complete removal of a lesion, considered to be an early glottic cancer.Methods: Between January 2015 to February 2017 patients with the clinical appearance of an early glottic cancer, who were candidates for (SSTLM) management protocol, were included in this study. Type of cordectomy was determined by pre- and intra-operative evaluation of the extent of lesion in cord layers.Results: Thirty patients (6 females, 24 males; mean age 65 years) underwent SSTLM. Twenty-two patients had malignant histopathological diagnosis of severe dysplasia or Cis in 4 patients, microinvasice carcinoma in 3 patients and invasive carcinoma in 15 patients (T1a tumor in 14 and T1b tumor in 1). Eight patients had a nonmalignant histological diagnosis of keratosis without atypia in 2 patients, mild dysplasia in 2 patients and moderate dysplasia in 3 patients. Based on pre- and intra-operative evaluation, 14 subepithelial (type I), 10 subligamental (type II), and 6 transmuscular (type III) cordectomies were performed. Comparison of cordectomies types with postoperative histopathologic diagnosis showed an adequate extent of resection in 26 out of 30 patients (87%). Considering only patients without recent background of direct laryngoscopy and biopsy, an adequate resection was performed in 90% of patients. None of the patients was further treated by external beam radiation. At average follow-up of 21 months, none of the patients developed local recurrence.Conclusion: In selected cases, a SSTLM for clinical appearance of an early glottic cancer, allows a reliable histopathologic diagnosis and a high local control rate with favorable cost effectiveness. A careful pre- and intraoperative evaluation for selecting the appropriate cases for this management is required in order to avoid under- or over-treatment. |
topic |
glottic cancer CO2 laser excisional biopsy single stage transoral laser microsurgery complete removal |
url |
https://www.frontiersin.org/article/10.3389/fonc.2018.00298/full |
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