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CO2 transoral laser microsurgery for early glottic carcinoma with anterior commissure involvement

  • Author Footnotes
    1 Yetao Yin and Qian Cai contributed equally to this work.
    Yetao Yin
    Footnotes
    1 Yetao Yin and Qian Cai contributed equally to this work.
    Affiliations
    Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China

    Department of Otolaryngology, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
    Search for articles by this author
  • Author Footnotes
    1 Yetao Yin and Qian Cai contributed equally to this work.
    Qian Cai
    Footnotes
    1 Yetao Yin and Qian Cai contributed equally to this work.
    Affiliations
    Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
    Search for articles by this author
  • Yiqing Zheng
    Affiliations
    Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
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  • Xiaoming Huang
    Affiliations
    Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
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  • Jieren Peng
    Affiliations
    Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
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  • Faya Liang
    Affiliations
    Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
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  • Jinshan Yang
    Affiliations
    Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
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  • Wenjun Chen
    Affiliations
    Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
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  • Yuejia Su
    Affiliations
    Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
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  • Zhong Guan
    Correspondence
    Corresponding author at: 107 Yan Jiang West Road Guangzhou P.R. China.
    Affiliations
    Department of Otorhinolaryngology-Head and Neck Surgery, Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University, Guangzhou, China
    Search for articles by this author
  • Author Footnotes
    1 Yetao Yin and Qian Cai contributed equally to this work.
Published:September 23, 2022DOI:https://doi.org/10.1016/j.anl.2022.09.006

      Abstract

      Objective

      Anterior commissure (AC) involvement is an unfavorable factor for transoral laser microsurgery (TLM) treatment of early glottic carcinoma (EGC). This study aimed to evaluate the therapeutic efficacy of TLM treatment for EGC with AC involvement.

      Methods

      From 2008 to 2017, 177 patients with T1-T2 EGC with AC involvement were retrospectively included and divided into the TLM group (n=115) receiving CO2 laser TLM and the control group undergoing open surgery (n=62). The survival outcomes, postoperative complications, laryngeal preservation rate, recurrence and the phonological results were compared between groups.

      Result

      The TLM group had significantly reduced hospital stay, hospitalization costs, and intraoperative blood loss as compared with the control group. The tracheotomy rate was significantly higher in the control group (96.8% vs. 0%). The 5-year overall survival (OS) was 89.6% and 85.5% in the TLM group and control group, respectively. Log-rank test showed no difference in survival rate between the two groups. There was no significant difference in laryngeal preservation rate and overall recurrence rate between groups. In postoperative vocal function evaluation, there were significant differences in the overall grade (G), the roughness (R), the breathiness (B), Voice Handicap Index-10 (VHI-10), Jitter, Shimmer, noise/harmonic ratio (NHR), maximum phonation time (MPT), phonation threshold pressure (PTP) between the two groups.

      Conclusion

      For EGC with AC involvement, TLM has similar survival outcomes with the open surgery, but has better postoperative voice outcomes. Meanwhile, TLM can effectively reduce intraoperative blood loss, hospitalization time, hospitalization costs and postoperative complications.

      Keywords

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