Long-term Oncologic Outcomes of 1188 Tis-T2 Glottic Cancers Treated by Transoral Laser Microsurgery.

[OBJECTIVE] To evaluate long-term disease-specific survival (DSS) and organ preservation (OP) rates in patients affected by Tis-T2 glottic squamous cell carcinoma (SCC) treated by carbon dioxide transoral laser microsurgery (CO TOLMS).

[STUDY DESIGN] Single-center retrospective cohort study.

[SETTING] Tertiary academic hospital.

[METHODS] The study included patients treated by CO TOLMS for Tis-T2 glottic SCC at the Department of Otorhinolaryngology-Head and Neck Surgery of the University of Brescia, Italy, from 1988 to 2018. The male:female ratio was 11.2:1, and the mean age was 64 years (range, 31-95). T categories were distributed as follows: 124 (10%) Tis, 646 (54%) T1a, 172 (15%) T1b, and 246 (21%) T2.

[RESULTS] Ten- and 20-year DSS rates were 97.6% and 96.3%, respectively, and 10- and 20-year OP rates were 94.7% and 93%. During the follow-up, 91% of patients were treated by CO TOLMS alone, while the remaining needed adjunctive treatments. Assessing the impact of multiple sessions of CO TOLMS, DSS showed no significant difference in terms of patients treated by 1, 2, or >2 procedures. Conversely, patients treated by >2 sessions of CO TOLMS showed a significantly worse OP rate.

[CONCLUSIONS] Our series validates CO TOLMS as a long-term treatment strategy for early glottic SCC. Salvage CO TOLMS provided optimal results in terms of DSS and OP in patients with recurrence after previous transoral surgery.