Oncological Impact of Surgical Margin Status After Transoral Laser Microsurgery for Early Glottic Cancer.

[BACKGROUND] Transoral laser microsurgery is a well-established treatment for early glottic cancer. However, managing patients with close/positive margins remains debated. This study analyzes the relationship between resection margins and oncologic outcomes.

[METHODS] Patients with early glottic cancer who underwent transoral laser microsurgery were included. We compared clinical characteristics, recurrence-free survival, laryngeal preservation, and disease-specific survival between negative and close/positive margin groups.

[RESULTS] Among 107 patients, 49 (45.8%) had close/positive margins. The recurrence-free survival rate was significantly lower in the close/positive margin group. Anterior commissure involvement was a significant risk factor for recurrence. The median recurrence time for the close/positive margin group was 18.5 months, similar to the negative margin group. Laryngeal preservation and disease-specific survival were similar between groups with > 95%.

[CONCLUSIONS] Patients with close/positive margins in early glottic cancer showed similar disease-specific survival and laryngeal preservation rates as negative margins; despite lower recurrence-free survival, suggesting a follow-up approach is sufficient.