Oncologic outcomes of patients with positive margins after laser cordectomy for T1 and T2 glottic squamous cell carcinoma

Head and Neck - Tập 38 Số 12 - Trang 1804-1809 - 2016
Quentin Charbonnier1,2, Anne-Sophie Thisse1,2, Laurent Sleghem1, F. Mouawad3,1, Dominique Chevalier3,1, C. Page4, G. Mortuaire5,1
1Otorhinolaryngology – Head and Neck Surgery Department University Hospital Lille France
2Quentin Charbonnier and Anne-Sophie Thisse contributed equally to this work.
3Institute for Cancer Research of Lille‐ Inserm U837 Université de Lille Lille France
4Otorhinolaryngology – Head and Neck Surgery Department University Hospital Amiens France
5Lille Inflammation Research International Center ‐Inserm U995 Université de Lille Lille France

Tóm tắt

AbstractBackground

The oncologic impact of surgical margins after transoral laser microsurgery (TLM) for T1 and T2 glottic carcinoma is controversial. The purpose of this study was to assess the prognostic value of margin status in terms of local control.

Methods

Records of 266 patients treated from 1990 to 2013 were evaluated. Patients with previous cordectomy or without preoperative CT scan were excluded from the study.

Results

A total 110 patients (85 T1a, 8 T1b, and 17 T2) were enrolled. A local recurrence was observed in 23 patients. Five‐year disease‐free survival was significantly impaired in patients with positive margins (p = .009) and in patients with deep involvement of the vocal muscle (p = .004).

Conclusion

The present study shows that invaded margin is a factor of poor local control even though laser vaporization was systematically applied after resection. In case of deep vocal fold involvement, TLM should be extended beyond the vocal muscle to improve local control. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1804–1809, 2016

Từ khóa


Tài liệu tham khảo

10.1016/j.anorl.2011.05.006

10.1097/01.mlg.0000184524.23282.74

10.1155/2014/464781

Higgins KM, 2009, Treatment of early‐stage glottic cancer: meta‐analysis comparison of laser excision versus radiotherapy, J Otolaryngol Head Neck Surg, 38, 603

10.1002/lary.24012

10.1186/1477-7819-10-178

10.1002/hed.24007

10.1002/hed.21278

10.1001/archoto.2009.10

10.1002/lary.24080

10.1080/00016480802441739

10.1002/hed.20997

10.1177/0194599811433270

10.1016/j.otc.2008.01.014

10.1097/01.mlg.0000251165.48830.89

10.1007/s00405-007-0279-z

10.1016/j.ejso.2008.01.012

10.1002/lary.23875

10.1001/archotol.133.9.882

10.1016/j.otc.2015.04.007

10.1007/s00405-009-1101-x

Rigby MH, 2012, T2 glottic carcinoma: analysis of recurrences in 36 cases undergoing primary transoral laser microsurgery resection, J Otolaryngol Head Neck Surg, 41, S85

Bertrand M, 2010, CT scan, MR imaging and anatomopathologic correlation in the glottic carcinoma T1‐T2 [in French], Rev Laryngol Otol Rhinol (Bord), 131, 51

10.1002/hed.23389

10.1016/j.anl.2007.08.001