CO2 laser cordectomy for early-stage glottic carcinoma:: A long-term follow-up of 156 cases

Objectives: To define when laser resection of early-stage glottic carcinoma is indicated and to compare the results obtained by laser surgery with other therapeutic options. Study Design: Retrospective study of 151 patients treated from April 1982 to June 1996 in the Department of Otorhinolaryngology at "La Sapienza" University. We provide analysis of indications, techniques, and oncologic results of this study. Methods: Glottic tumors were treated with type III, type IV, and type Va cordectomies according to the classification of endoscopic cordectomies proposed by the European Laryngological Society in 2000. Results: The results are summarized as follows: all patients with carcinoma in situ Tis are free of disease with local control rate at 3 years of 100%; 2 died of other causes-without evidence of local recurrence with an overall survival rate at 3 years of 83.2%. Of the 117 patients with stage T1a cancer, 110 are free of disease at 3 years with local control rate of 94%; 4 patients died of other causes without evidence of local recurrence with an overall survival rate of 96.5%. Of the 22 patients with stage T1b cancer, 20 are free of disease at 3 years with a local control rate of 91%; 1 patient died of other causes without evidence of local recurrence with an overall survival rate at 3 years of 95.4%. Conclusions: According to our experience, we can conclude that endoscopic laser surgery is an efficacious and cost-effective treatment for early stage glottic cancer.