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CO2 laser cordectomy for glottic squamous cell carcinoma involving the anterior commissure: voice and oncologic outcomes

  • Laryngology
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Abstract

Transoral CO2 laser cordectomy for squamous cell carcinoma (SCC) of the glottis has resulted in excellent voice and oncologic outcomes as compared with non-surgical therapy. However, published experience with primary CO2 laser cordectomy specifically for glottic SCC involving the anterior commissure (AC) is limited. A review of single academic institution experience with CO2 laser cordectomy for glottic SCC involving the AC. Patients undergoing European Laryngological Society (ELS) classification cordectomy type Va or type VI between 2005 and 2013 were included. Post-surgical voice analysis was performed by speech language pathologists (SLP) from the reporting institution. Thirty patients were identified for inclusion. Mean post-surgical follow-up time was 47.6 months (range 11–59). Initial local recurrence was identified in 5/30 (16.7 %) patients. 2/5 recurrences were successfully salvaged by repeat CO2 laser resections, 2/5 ultimately required salvage total laryngectomy, and 1/5 patient developed a second primary preventing further curative treatment. Overall laryngeal preservation rate was 28/30 (93.3 %). Overall survival of the study cohort was 96.7 %. Mean postoperative voice handicap index-120 score was 36.9 (SD = 21.4). Perceptual analysis performed on the GRBAS scale resulted in mean scores: G = 2.1 (SD = 0.9), R = 1.3 (SD = 1.1), B = 1.6 (SD = 1.2). Though cancers involving the AC represent an aggressive subgroup of glottic SCC, CO2 laser cordectomy results in encouraging oncologic and voice outcomes without the need for further therapy in the majority of cases. Clinical trials are encouraged to further define optimal treatment recommendations for glottic SCC involving the AC.

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References

  1. Pradhan SA, Pai PS, Neeli SI, D’Cruz AK (2003) Transoral laser surgery for early glottic cancers. Arch Otolaryngol Head Neck Surg 129:623–625

    Article  PubMed  Google Scholar 

  2. Mortuaire G, Francois J, Wiel E, Chevalier D (2006) Local recurrence after CO2 laser cordectomy for early glottic carcinoma. Laryngoscope 116:101–105

    Article  CAS  PubMed  Google Scholar 

  3. Rödel RM, Steiner W, Müller RM, Kron M, Matthias C (2009) Endoscopic laser surgery of early glottic cancer: involvement of the anterior commissure. Head Neck 31(5):583–592

    Article  PubMed  Google Scholar 

  4. Roh JL, Kim DH, Kim SY, Park CI (2007) Quality of life and voice in patients after laser cordectomy for Tis and T1 glottic carcinomas. Head Neck 29(11):1010–1016

    Article  PubMed  Google Scholar 

  5. Taylor SM, Kerr P, Fung K, Aneeshkumar MK, Wilke D, Jiang Y, Scott J, Phillips J, Hart RD, Trites JR, Rigby MH (2013) Treatment of T1b glottic SCC: laser vs. radiation—a Canadian multicenter study. J Otolaryngol Head Neck Surg. 19(42):22

    Article  Google Scholar 

  6. Remacle M, Eckel HE, Antonelli A, Brasnu D, Chevalier D, Friedrich G, Olofsson J, Rudert HH, Thumfart W, de Vincentiis M, Wustrow TP (2000) Endoscopic cordectomy. A proposal for a classification by the working committee, European Laryngological Society. Eur Arch Otorhinolaryngol 257(4):227–231

    Article  CAS  PubMed  Google Scholar 

  7. Remacle M, Van Haverbeke C, Eckel H, Bradley P, Chevalier D, Djukic V, de Vicentiis M, Friedrich G, Olofsson J, Peretti G, Quer M, Werner J (2007) Proposal for revision of the European Laryngological Society classification of endoscopic cordectomies. Eur Arch Otorhinolaryngol 264(5):499–504

    Article  PubMed  Google Scholar 

  8. Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jacobson G, Benninger MS, Newman CW (1997) The voice handicap index (VHI) development and validation. Am J Speech Lang Pathol 6(3):66–70

    Article  Google Scholar 

  9. De Bodt MS, Wuyts FL, Van de Heyning PH, Croux C (1997) Test-retest study of the GRBAS scale: influence of experience and professional background on perceptual rating of voice quality. J Voice 11(1):74–80

    Article  PubMed  Google Scholar 

  10. Broyles EN (1943) The anterior commissure tendon. Ann Otol Rhinol Laryngol 52:342–345

    Google Scholar 

  11. Kirchner JA, Fischer JJ (1975) Anterior commissure cancer—a clinical and laboratory study of 39 cases. Can J Otolaryngol 4(4):637–643

    CAS  PubMed  Google Scholar 

  12. Rucci L, Bocciolini C, Franchi A, Ferlito A, Casucci A (2004) Epidermal growth factor receptor and p53 expression in T1–T2 glottic cancer involving the anterior or posterior commissure. Acta Otolaryngol 124(1):102–106

    Article  CAS  PubMed  Google Scholar 

  13. Bradley PJ, Rinaldo A, Suárez C, Shaha AR, Leemans CR, Langendijk JA, Patel SG, Ferlito A (2006) Primary treatment of the anterior vocal commissure squamous carcinoma. Eur Arch Otorhinolaryngol 263(10):879–888

    Article  PubMed  Google Scholar 

  14. Lillie JC, DeSanto LW (1973) Transoral surgery of early cordal carcinoma. Trans Am Acad Ophthalmol Otolaryngol 77(2):92–96

    Google Scholar 

  15. Laccourreye O, Weinstein G, Brasnu D, Trotoux J, Laccourreye H (1991) Vertical partial laryngectomy: a critical analysis of local recurrence. Ann Otol Rhinol Laryngol 100(1):68–71

    Article  CAS  PubMed  Google Scholar 

  16. Smee RI, Meagher NS, Williams JR, Broadley K, Bridger GP (2010) Role of radiotherapy in early glottic carcinoma. Head Neck 32(7):850–859

    PubMed  Google Scholar 

  17. Szyfter W, Leszczyńska M, Wierzbicka M, Kopeć T, Bartochowska A (2013) Value of open horizontal glottectomy in the treatment for T1b glottic cancer with anterior commissure involvement. Head Neck 35(12):1738–1744

    Article  PubMed  Google Scholar 

  18. Bajaj Y, Uppal S, Sharma RK, Grace AR, Howard DM, Nicolaides AR, Coatesworth AP (2011) Evaluation of voice and quality of life after transoral endoscopic laser resection of early glottic carcinoma. J Laryngol Otol 125(7):706–713

    Article  CAS  PubMed  Google Scholar 

  19. Agarwal JP, Baccher GK, Waghmare CM, Mallick I, Ghosh-Laskar S, Budrukkar A, Pai P, Chaturvedi P, D’Cruz A, Shrivastava SK, Dinshaw KA (2009) Factors affecting the quality of voice in the early glottic cancer treated with radiotherapy. Radiother Oncol 90(2):177–182

    Article  PubMed  Google Scholar 

  20. Iwata S, von Leden H (1970) Phonation quotient in patients with laryngeal diseases. Folia Phoniatr (Basel) 22(2):117–128

    Article  CAS  Google Scholar 

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Conflict of interest

Dr. Mendelsohn is a paid consultant for Lumenis Inc.

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Authors and Affiliations

  1. Department of Head and Neck Surgery, Head and Neck Robotic Surgery Program, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Abie H. Mendelsohn

  2. Head and Neck Surgery Department, Catholic University of Louvain at Mont-Godinne, Yvoir, Belgium

    Devora Kiagiadaki, Georges Lawson & Marc Remacle

Authors
  1. Abie H. Mendelsohn
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  2. Devora Kiagiadaki
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  3. Georges Lawson
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  4. Marc Remacle
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Correspondence to Abie H. Mendelsohn.

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Mendelsohn, A.H., Kiagiadaki, D., Lawson, G. et al. CO2 laser cordectomy for glottic squamous cell carcinoma involving the anterior commissure: voice and oncologic outcomes. Eur Arch Otorhinolaryngol 272, 413–418 (2015). https://doi.org/10.1007/s00405-014-3368-9

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  • DOI: https://doi.org/10.1007/s00405-014-3368-9

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