Transoral laser microsurgery outcomes with early glottic cancer: the Dalhousie University experience

Objective: To report the results of transoral laser microsurgery for the treatment of early glottic cancer at our institution. Design: Cohort study. Retrospective review of charts of patients diagnosed with tumour stage 1 or 2 (early stage; no nodes ormetastases), previously untreated, primary glottic cancer, treated with transoral laser microsurgery at the Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada. The minimum follow-up period was two years. Setting: Tertiary care head and neck cancer centre. Participants: Fifty-three patients treated between January 2002 and November 2007. Outcome measure: Kaplan-Meier survival analysis for disease-free survival, overall survival and laryngectomy-free survival, at five years. Results: The group comprised 46 men and seven women, with a mean age of 66 years (range 30-84 years). Mean follow up was 40 months (range 12-89 months). There were four cases of complications (7.5 per cent). Kaplan-Meier survival analysis revealed a five-year disease-free survival (including salvage) of 96.2 per cent, a five-year overall survival (all causes) of 88.8 per cent and a five-year laryngectomy-free survival of 98.1 per cent. Conclusion: Transoral laser microsurgery is a safe and effective initial treatment for early laryngeal cancer, and has high rates of laryngeal preservation and disease-free survival.