The Utility of Second-Look Operation After Laser Microresection of Glottic Carcinoma Involving the Anterior Commissure.

Authors:	Jong-Lyel Roh, Dong-Hyun Kim, Chan Il Park
Language:	ENG.
Date:	23-5-2008
Journal:	The Laryngoscope (0023-852X)
Release:	Laryngoscope. 9 May 2008
Abstract:	OBJECTIVES/HYPOTHESIS:: Transoral laser microsurgery for the treatment of glottic carcinoma with anterior commissure (A-com) involvement is associated with a high rate of recurrence. We prospectively evaluated the outcomes of laser microsurgery and the efficacy of second-look operation in these patients. STUDY DESIGN:: Prospective evaluation. METHODS:: Twenty-seven patients with glottic carcinomas involving the A-com underwent transoral laser microresection. Twenty-five patients underwent second-look operations 3 months after laser surgery. RESULTS:: After transoral laser microresection, all patients achieved microscopic clear resection margins. Local recurrence was found in 7 of 27 patients (25.9%). Regional recurrence was found in two patients. Patients with recurrences underwent laser re-resection or neck dissection; four received radiotherapy, two lost their larynxes, and three died of disease. At second-look operation, early local recurrence was found in two patients, and anterior glottic webs and granulomas causing dysphonia were treated in 8 and 11 patients, respectively. CONCLUSIONS:: Laser microsurgery is an effective treatment modality in early glottic cancer with A-com involvement but is still associated with a high rate of recurrence. Second-look operation may help detect early local recurrence and treat postoperative airway or voice problems.
Copyright:	The Laryngoscope From the Department of Otolaryngology (j.-l.r.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and the Department of Otolaryngology-Head and Neck Surgery (d.-h.k., c.i.p.), Chungnam National University College of Medicine, Daejeon, Republic of Korea.
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