Outcomes Following Transoral Laser Microsurgery for T1b and T2a Glottic Squamous Cell Carcinoma With and Without Anterior Commissure Involvement: A Retrospective Chart Review
PMCID: PMC12177246
PMID: 40530452
DOI: 10.1177/19160216251348424
Journal: Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
Publication Date: 2025-6-18
Authors: Patel D, Taylor V, MacKay C, den Besten C, Rigby MH, et al.
Key Points
- TLM demonstrates comparable oncological outcomes across T1b, T2AC, and T2noAC glottic SCC groups
- 5-year laryngeal preservation rate was high: T1b (94.3%), T2AC (92.1%), T2noAC (94.4%)
- AC involvement should be considered on a case-by-case basis, with further research needed to establish definitive treatment guidelines
Summary
This retrospective study investigated oncological and functional outcomes of transoral laser microsurgery (TLM) in glottic squamous cell carcinoma (SCC), comparing T1b, T2a with anterior commissure (AC) involvement (T2AC), and T2a without AC involvement (T2noAC). The research aimed to understand the impact of AC involvement on treatment outcomes in early-stage laryngeal cancer, addressing a critical gap in understanding tumor management strategies.
The study analyzed 117 patients, revealing no statistically significant differences in local control, disease-specific survival, overall survival, or laryngeal preservation across the three groups. Notably, voice-related quality of life improvements were only significant in the T1b cohort at 6 and 12 months post-surgery. While positive margin rates were higher in the T2AC group, prompt re-resection prevented significant differences in long-term survival outcomes, highlighting the potential advantages of TLM in managing these tumors.