Surgical treatment of T1b glottic tumor, 10-years follow-up

D. Marcotullio, M. de Vincentiis, G. Iannella, C. Bigelli, G. Magliulo

“Organi di Senso” Department, “Sapienza” University, Rome, Italy. giuseppemagliuloorl@yahoo.com

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• Otorhinolaryngology

BACKGROUND: The TNM classification of glottic tumors defined T1b as a tumor involving both vocal cords with normal mobility of such.
In the last fifteen years, in the medical literature, the role of open surgery for management of laringeal cancer has decreased considerably owing to the development of transoral laser microsurgery which is an oncologically and functionally reliable treatment particularly for early glottic cancers.

AIM: Report the efficacy of different surgical techniques (laser CO2 cordectomy or supracricoid partial laryngectomy) in T1b glottic cancers treatment with a 10-years follow-up.

PATIENTS AND METHODS: 92 patients with T1b glottic cancer undergoing surgery between 1986 and 2002, of which 39 were treated with CO2 laser cordectomy while 53 with supracricoid partial laryngectomy (14 crico-hyoid-pexy and 39 crico-hyoid-epiglotto-pexy). Each of the three groups was recalled and evalued with the aim to calculate the survival, initially at 3 and 5 years and thereafter, provide a 10 years follow-up, including local recurrence.

RESULTS: 10 years absolute survival of the 39 patient treated with CO2 laser was 56.25%, while that of the two groups subjected to supracricoid partial laryngectomy was respectively of 66.6% for crico-hyoid-pexy and 58.82% for crico-hyoid-epiglotto-pexy.

CONCLUSIONS: Our data suggest an excellent absolute survival also after 10 years follow-up. Since both the CO2 laser and supracricoid partial laryngectomy show similar local control and survival rates we can’t determine with certainty the best therapeutic approach as claimed by a great number of literature studies.

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