ENDOSCOPIC CO2 LASER SURGERY FOR EARLY GLOTTIC CANCER IN PATIENTS WHO ARE CANDIDATES FOR

Abstract: Background. Treatment of early glottic malignan-cies is controversial, particularly if postoperative endoscopy shows minimal/no residual disease. Methods. In a prospective nonrandomized study, we per-formed endoscopic laser surgery with curative intent in 59 pa-tients with early glottic carcinoma presenting for radiotherapy after diagnosis elsewhere by random biopsy or cordal stripping. We analyzed outcomes and residual cancer in the specimen. Results. Clinical staging elsewhere did not correspond to (usually underestimated) the pathologic stage in 60.7%. In 22%, no tumor was identified on pathologic examination. After 35.3 months (mean), 93.2 % were alive with no evidence of dis-ease. Local control was achieved in 98.3 % of the patients, and 13.5 % of the patients required radiotherapy. The larynx was conserved in 98.3%. Conclusions. Biopsy/stripping are best abandoned for per-sistent glottic lesions. A single laser endoscopic procedure provides reliable staging and definitive treatment in most cases using fewer resources. Biopsied patients presenting for treat-ment should be offered laser surgery as an alternative t