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Transoral laser surgery versus radiotherapy for tumour stage 1a or 1b glottic squamous cell carcinoma: systematic review of local control outcomes

Published online by Cambridge University Press:  09 July 2013

J O'Hara ,
A Markey  and
J J Homer
J O'Hara
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Sunderland Royal Hospital, UK
A Markey
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Manchester Academic Health Science Centre, Manchester Royal Infirmary, UK
J J Homer*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Manchester Academic Health Science Centre, Manchester Royal Infirmary, UK Department of Otolaryngology Head and Neck Surgery, University of Manchester, UK
*
Address for correspondence: Professor Jarrod J Homer, Department of Otolarynglogy, Manchester Royal Infirmary and Christie Hospital, Oxford Road, Manchester M13 9DL, UK Fax: +44 (0)161 276 5003 E-mail: Jarrod.Homer@manchester.ac.uk
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Abstract

Background:

Previous literature reviews comparing transoral laser surgery versus radiotherapy for glottic carcinoma treatment have analysed ‘early stage’ disease as one group. The current review aimed to assess local control outcomes, comparing these two treatment modalities, specifically for either tumour stage 1a or stage 1b lesions.

Methods:

The three authors conducted independent, structured literature searches. Simple weighted means were calculated.

Results:

Thirty-six publications were analysed. Three-year local control rates for tumour stage 1a tumours were 88.9 per cent for transoral laser surgery (n = 1308) and 89.3 per cent for radiotherapy (n = 2405). For tumour stage 1b tumours, the local control rates were 76.8 per cent for transoral laser surgery (n = 194) and 86.2 per cent for radiotherapy (n = 492).

Conclusion:

From this analysis of level four evidence, there was no demonstrable difference in local control rates for tumour stage 1a glottic squamous cell carcinoma treated by transoral laser surgery or radiotherapy. There was a trend towards improved local control of tumour stage 1b tumours treated with radiotherapy, but this finding was based on a limited number of published outcomes (n = 194).

Keywords

LarynxVocal CordsCarcinomaRadiotherapyLasersSurgical ProceduresLaryngoscopicPrognosis

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 8 , August 2013 , pp. 732 - 738
Copyright
Copyright © JLO (1984) Limited 2013 

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References

1Office for National Statistics. Cancer Statistics Registrations 2008. London: Vital Statistics Outputs Branch, 2008Google Scholar
2Dey, P, Arnold, D, Wight, R, MacKenzie, K, Kelly, C, Wilson, J. Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancer. Cochrane Database Syst Rev 2002:(2):CD002027CrossRefGoogle ScholarPubMed
3Higgins, KM, Shah, MD, Ogaick, MJ, Enepekides, D. Treatment of early-stage glottic cancer: meta-analysis comparison of laser excision versus radiotherapy. J Otolaryngol Head Neck Surg 2009;38:603–12Google ScholarPubMed
4Spielmann, PM, Majumdar, S, Morton, RP. Quality of life and functional outcomes in the management of early glottic carcinoma: a systematic review of studies comparing radiotherapy and transoral laser microsurgery. Clin Otolaryngol 2010;35:373–82CrossRefGoogle ScholarPubMed
5Rucci, L, Romagnoli, P, Scala, J. CO(2) laser therapy in Tis and T1 glottic cancer: indications and results. Head Neck 2010;32:392–8CrossRefGoogle ScholarPubMed
6Leong, SC, Kathan, C, Mortimore, S. Early outcomes after transoral CO2 laser resection of laryngeal and hypopharyngeal squamous cell carcinoma: one centre's experience. J Laryngol Otol 2010;124:185–93CrossRefGoogle ScholarPubMed
7Sachse, F, Stoll, W, Rudack, C. Evaluation of treatment results with regard to initial anterior commissure involvement in early glottic carcinoma treated by external partial surgery or transoral laser microresection. Head Neck 2009;31:531–7CrossRefGoogle ScholarPubMed
8Schrijvers, ML, van Riel, EL, Langendijk, JA, Dikkers, FG, Schuuring, E, van der Wal, JE et al. Higher laryngeal preservation rate after CO2 laser surgery compared with radiotherapy in T1a glottic laryngeal carcinoma. Head Neck 2009;31:759–64CrossRefGoogle ScholarPubMed
9Hsin, L-J, Fang, T-J, Chang, K-P, Fang, K-H, Tsang, N-M, Chen, Y-L et al. Transoral endoscopic CO2 laser microsurgery for early laryngeal cancers. Chang Gung Med J 2009;32:517–25Google ScholarPubMed
10Thurnher, D, Erovic, BM, Frommlet, F, Brannath, W, Ehrenberger, K, Jansen, B et al. Challenging a dogma – surgery yields superior long-term results for T1a squamous cell carcinoma of the glottic larynx compared to radiotherapy. Eur J Surg Oncol 2008;34:692–8CrossRefGoogle ScholarPubMed
11Chone, CT, Yonehara, E, Martins, JEF, Altemani, A, Crespo, AN. Importance of anterior commissure in recurrence of early glottic cancer after laser endoscopic resection. Arch Otolaryngol Head Neck Surg 2007;133:882–7CrossRefGoogle ScholarPubMed
12Goor, KM, Peeters, AJGE, Mahieu, HF, Langendijk, JA, Leemans, CR, Verdonck-de Leeuw, IM et al. Cordectomy by CO2 laser or radiotherapy for small T1a glottic carcinomas: costs, local control, survival, quality of life, and voice quality. Head Neck 2007;29:128–36CrossRefGoogle ScholarPubMed
13Hartl, DM, De Monès, E, Hans, S, Janot, F, Brasnu, D. Treatment of early-stage glottic cancer by transoral laser resection. Ann Otol Rhinol Laryngol 2007;116:832–6CrossRefGoogle ScholarPubMed
14Sigston, E, de Mones, E, Babin, E, Hans, S, Hartl, DM, Clement, P et al. Early-stage glottic cancer: oncological results and margins in laser cordectomy. Arch Otolaryngol Head Neck Surg 2006;132:147–52CrossRefGoogle ScholarPubMed
15Mortuaire, G, Francois, J, Wiel, E, Chevalier, D. Local recurrence after CO2 laser cordectomy for early glottic carcinoma. Laryngoscope 2006;116:101–5CrossRefGoogle ScholarPubMed
16Ledda, GP, Puxeddu, R. Carbon dioxide laser microsurgery for early glottic carcinoma. Otolaryngol Head Neck Surg 2006;134:911–15CrossRefGoogle ScholarPubMed
17Maurizi, M, Almadori, G, Plaudetti, G, De Corso, E, Galli, J. Laser carbon dioxide cordectomy versus open surgery in the treatment of glottic carcinoma: our results. Otolaryngol Head Neck Surg 2005;132:857–61CrossRefGoogle ScholarPubMed
18Bocciolini, C, Presutti, L, Laudadio, P. Oncological outcome after CO2 laser cordectomy for early-stage glottic carcinoma. Acta Otorhinolaryngol Ital 2005;25:86–93Google ScholarPubMed
19Krengli, M, Policarpo, M, Manfredda, I, Aluffi, P, Gambaro, G, Panella, M et al. Voice quality after treatment for T1a glottic carcinoma – radiotherapy versus laser cordectomy. Acta Oncol 2004;43:284–9CrossRefGoogle ScholarPubMed
20Steiner, W, Ambrosch, P, Rodel, RMW, Kron, M. Impact of anterior commissure involvement on local control of early glottic carcinoma treated by laser microresection. Laryngoscope 2004;114:1485–91CrossRefGoogle ScholarPubMed
21Shvero, J, Koren, R, Zohar, L, Hadar, T, Marshak, G, Gal, R et al. Laser surgery for the treatment of glottic carcinomas. Am J Otolaryngol 2003;24:28–33CrossRefGoogle ScholarPubMed
22Pradhan, SA, Pai, PS, Neeli, SI, D'Cruz, AK, Pradhan, SA, Pai, PS et al. Transoral laser surgery for early glottic cancers. Arch Otolaryngol Head Neck Surg 2003;129:623–5CrossRefGoogle ScholarPubMed
23Gallo, A, de Vincentiis, M, Manciocco, V, Simonelli, M, Fiorella, ML, Shah, JP. CO2 laser cordectomy for early-stage glottic carcinoma: a long-term follow-up of 156 cases. Laryngoscope 2002;112:370–4CrossRefGoogle ScholarPubMed
24Moreau, PR. Treatment of laryngeal carcinomas by laser endoscopic microsurgery. Laryngoscope 2000;110:1000–6CrossRefGoogle ScholarPubMed
25Spector, JG, Sessions, DG, Chao, KS, Haughey, BH, Hanson, JM, Simpson, JR et al. Stage I (T1 N0 M0) squamous cell carcinoma of the laryngeal glottis: therapeutic results and voice preservation. Head Neck 1999;21:707–173.0.CO;2-2>CrossRefGoogle Scholar
26Rudert, HH, Werner, JA, Rudert, HH, Werner, JA. Endoscopic resections of glottic and supraglottic carcinomas with the CO2 laser. Eur Arch Otorhinolaryngol 1995;252:146–8CrossRefGoogle ScholarPubMed
27Epstein, BE, Lee, DJ, Kashima, H, Johns, ME. Stage T1 glottic carcinoma: results of radiation therapy or laser excision. Radiology 1990;175:567–70CrossRefGoogle ScholarPubMed
28Pontes, P, Brasil Ode, O, Amorim Filho, F de S, Moraes, BT, Pontes, A, Caporrino Neto, J. Radiotherapy for early glottic cancer and salvage surgery after recurrence [in Portuguese]. Braz J Otorhinolaryngol 2011;77:299–302CrossRefGoogle ScholarPubMed
29Jones, DA, Mendenhall, CM, Kirwan, J, Morris, CG, Donnan, A, Holwerda, S et al. Radiation therapy for management of T1-T2 glottic cancer at a private practice. Am J Clin Oncol 2010;33:587–90CrossRefGoogle ScholarPubMed
30Chera, BS, Amdur, RJ, Morris, CG, Kirwan, JM, Mendenhall, WM. T1N0 to T2N0 squamous cell carcinoma of the glottic larynx treated with definitive radiotherapy. Int J Radiat Oncol Biol Phys 2010;78:461–6CrossRefGoogle ScholarPubMed
31Nomiya, T, Nemoto, K, Wada, H, Takai, Y, Yamada, S. Long-term results of radiotherapy for T1a and T1bN0M0 glottic carcinoma. Laryngoscope 2008;118:1417–21CrossRefGoogle ScholarPubMed
32Reddy, SP, Hong, RL, Nagda, S, Emami, B. Effect of tumor bulk on local control and survival of patients with T1 glottic cancer: a 30-year experience. Int J Radiat Oncol Biol Phys 2007;69:1389–94CrossRefGoogle Scholar
33Franchin, G, Minatel, E, Gobitti, C, Talamini, R, Vaccher, E, Sartor, G et al. Radiotherapy for patients with early-stage glottic carcinoma: univariate and multivariate analyses in a group of consecutive, unselected patients. Cancer 2003;98:765–72CrossRefGoogle Scholar
34Gowda, RV, Henk, JM, Mais, KL, Sykes, AJ, Swindell, R, Slevin, NJ. Three weeks radiotherapy for T1 glottic cancer: the Christie and Royal Marsden Hospital Experience. Radiother Oncol 2003;68:105–11CrossRefGoogle ScholarPubMed
35Johansen, LV, Grau, C, Overgaard, J. Glottic carcinoma – patterns of failure and salvage treatment after curative radiotherapy in 861 consecutive patients. Radiother Oncol 2002;63:257–67CrossRefGoogle ScholarPubMed
36Warde, P, O'Sullivan, B, Bristow, RG, Panzarella, T, Keane, TJ, Gullane, PJ et al. T1/T2 glottic cancer managed by external beam radiotherapy: the influence of pretreatment hemoglobin on local control. Int J Radiat Oncol Biol Phys 1998;41:347–53CrossRefGoogle ScholarPubMed
37Foote, RL, Buskirk, SJ, Grado, GL, Bonner, JA. Has radiotherapy become too expensive to be considered a treatment option for early glottic cancer? Head Neck 1997;19:692–7003.0.CO;2-0>CrossRefGoogle ScholarPubMed
38Klintenberg, C, Lundgren, J, Adell, G, Tytor, M, Norberg-Spaak, L, Edelman, R et al. Primary radiotherapy of T1 and T2 glottic carcinoma – analysis of treatment results and prognostic factors in 223 patients. Acta Oncol 1996;35(suppl 8):81–6CrossRefGoogle ScholarPubMed
39Pellitteri, PK, Kennedy, TL, Vrabec, DP, Beiler, D, Hellstrom, M. Radiotherapy. The mainstay in the treatment of early glottic carcinoma. Arch Otolaryngol Head Neck Surg 1991;117:297–301CrossRefGoogle ScholarPubMed
40Mittal, B, Rao, DV, Marks, JE, Perez, CA. Role of radiation in the management of early vocal cord carcinoma. Int J Radiat Oncol Biol Phys 1983;9:997–1002CrossRefGoogle ScholarPubMed