CONCLUSIONS: The presented concept of second-look microlaryngoscopy in patients treated with transoral laser surgery (TLS) for early glottic carcinoma is promising and warrants further studies to evaluate its benefits. OBJECTIVES: Clear surgical margins at the primary site influence the course of the disease in patients with laryngeal carcinoma who undergo TLS. Several factors may lead to a reduced sensitivity in detecting tumor remnants at the time of the initial procedure. We therefore developed the concept of second-look microlaryngoscopies to enable a microscopic and histologic reassessment at the primary tumor site to exclude residual carcinoma. PATIENTS AND METHODS: Patients were scheduled for two second-look microlaryngoscopies under general anesthesia at 8-10 weeks and 16-20 weeks after the initial TLS procedure. We analyzed the histopathologic findings of biopsies taken in the second-look microlaryngoscopies and the survival parameters of 181 patients treated with TLS for early laryngeal carcinoma. RESULTS: Carcinoma at the primary site was found in 5.1% of all patients within the first and in 11.5% of all patients within the second second-look microlaryngoscopy, although the preoperative indirect laryngoscopy was inconspicuous in most cases. The survival analysis showed a 5-year and 10-year disease-free survival of 96.3% and 92.7%, respectively. The disease-free survival was significantly decreased when carcinoma was found in the second-look microlaryngoscopy (p=0.004).
CONCLUSIONS: The presented concept of second-look microlaryngoscopy in patients treated with transoral laser surgery (TLS) for early glottic carcinoma is promising and warrants further studies to evaluate its benefits. OBJECTIVES: Clear surgical margins at the primary site influence the course of the disease in patients with laryngeal carcinoma who undergo TLS. Several factors may lead to a reduced sensitivity in detecting tumor remnants at the time of the initial procedure. We therefore developed the concept of second-look microlaryngoscopies to enable a microscopic and histologic reassessment at the primary tumor site to exclude residual carcinoma. PATIENTS AND METHODS: Patients were scheduled for two second-look microlaryngoscopies under general anesthesia at 8-10 weeks and 16-20 weeks after the initial TLS procedure. We analyzed the histopathologic findings of biopsies taken in the second-look microlaryngoscopies and the survival parameters of 181 patients treated with TLS for early laryngeal carcinoma. RESULTS:Carcinoma at the primary site was found in 5.1% of all patients within the first and in 11.5% of all patients within the second second-look microlaryngoscopy, although the preoperative indirect laryngoscopy was inconspicuous in most cases. The survival analysis showed a 5-year and 10-year disease-free survival of 96.3% and 92.7%, respectively. The disease-free survival was significantly decreased when carcinoma was found in the second-look microlaryngoscopy (p=0.004).
Authors: Mark D Wilkie; Kathryn A Lightbody; Daniel Lythgoe; Sankalap Tandon; Jeffrey Lancaster; Terrence M Jones Journal: Eur Arch Otorhinolaryngol Date: 2014-03-30 Impact factor: 2.503
Authors: Soon-Hyun Ahn; Hyun Jun Hong; Soon Young Kwon; Kee Hwan Kwon; Jong-Lyel Roh; Junsun Ryu; Jun Hee Park; Seung-Kuk Baek; Guk Haeng Lee; Sei Young Lee; Jin Choon Lee; Man Ki Chung; Young Hoon Joo; Yong Bae Ji; Jeong Hun Hah; Minsu Kwon; Young Min Park; Chang Myeon Song; Sung-Chan Shin; Chang Hwan Ryu; Doh Young Lee; Young Chan Lee; Jae Won Chang; Ha Min Jeong; Jae-Keun Cho; Wonjae Cha; Byung Joon Chun; Ik Joon Choi; Hyo Geun Choi; Kang Dae Lee Journal: Clin Exp Otorhinolaryngol Date: 2017-01-03 Impact factor: 3.372
Authors: Hans Edmund Eckel; Ricard Simo; Miquel Quer; Edward Odell; Vinidh Paleri; Jens Peter Klussmann; Marc Remacle; Elisabeth Sjögren; Cesare Piazza Journal: Eur Arch Otorhinolaryngol Date: 2020-10-14 Impact factor: 2.503