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<p>Transoral laser microsurgery (TLM) is widely used for the treatment of early-stage glottic cancer because it offers the potential for oncologic control while preserving laryngeal function. This study aimed to evaluate the 5-year oncologic and functional outcomes of TLM for early-stage glottic cancer at a single tertiary referral center. This retrospective single-center study included patients with histologically confirmed T1–T2N0M0 glottic squamous cell carcinoma who underwent TLM between January 2018 and December 2020 at our institution. Only patients with complete clinical records and a minimum follow-up duration of 5 years were included, with follow-up extended through 2025. Preoperative staging was based on clinical, endoscopic, and radiologic assessment, and all patients underwent contrast-enhanced computed tomography before surgery. Primary endpoints were 5-year local control, overall survival (OS), and disease-specific survival (DSS). Secondary endpoints included postoperative complications and functional outcomes related to voice and swallowing preservation. A total of 96 patients were included. The mean age was 61 ± 9 years, and 96.9% were male. Most patients had T1 disease (93.7%), while 6.3% had T2 disease. The median follow-up duration was 60 months (range, 60–72 months). At 5 years, the local control rate was 91.7%, with local recurrence observed in 8 patients (8.3%), all of whom underwent salvage total laryngectomy. The final laryngeal preservation rate was 91.7%. The 5-year OS and DSS rates were 89.6% and 100%, respectively. Postoperative complications were infrequent and generally manageable. No patient required permanent tracheostomy or long-term feeding tube support. Functional outcomes were derived retrospectively from clinical follow-up records; most patients maintained satisfactory swallowing, and voice quality was preserved at an acceptable level in the majority of cases. Transoral laser microsurgery demonstrated favorable 5-year oncologic outcomes with acceptable functional preservation in selected patients with early-stage glottic cancer. Careful patient selection, preoperative imaging assessment, standardized surgical technique, and intraoperative margin evaluation remain essential for optimizing outcomes.</p>

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Five-Year Outcomes of Transoral Laser Microsurgery for Early-Stage Glottic Cancer: A Single-Center Retrospective study

  • 期刊论文

  • 发表日期：

    2026年6月22日

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  • Nguyen Thanh Tuan,
  • Tran Phan Chung Thuy

摘要

Transoral laser microsurgery (TLM) is widely used for the treatment of early-stage glottic cancer because it offers the potential for oncologic control while preserving laryngeal function. This study aimed to evaluate the 5-year oncologic and functional outcomes of TLM for early-stage glottic cancer at a single tertiary referral center. This retrospective single-center study included patients with histologically confirmed T1–T2N0M0 glottic squamous cell carcinoma who underwent TLM between January 2018 and December 2020 at our institution. Only patients with complete clinical records and a minimum follow-up duration of 5 years were included, with follow-up extended through 2025. Preoperative staging was based on clinical, endoscopic, and radiologic assessment, and all patients underwent contrast-enhanced computed tomography before surgery. Primary endpoints were 5-year local control, overall survival (OS), and disease-specific survival (DSS). Secondary endpoints included postoperative complications and functional outcomes related to voice and swallowing preservation. A total of 96 patients were included. The mean age was 61 ± 9 years, and 96.9% were male. Most patients had T1 disease (93.7%), while 6.3% had T2 disease. The median follow-up duration was 60 months (range, 60–72 months). At 5 years, the local control rate was 91.7%, with local recurrence observed in 8 patients (8.3%), all of whom underwent salvage total laryngectomy. The final laryngeal preservation rate was 91.7%. The 5-year OS and DSS rates were 89.6% and 100%, respectively. Postoperative complications were infrequent and generally manageable. No patient required permanent tracheostomy or long-term feeding tube support. Functional outcomes were derived retrospectively from clinical follow-up records; most patients maintained satisfactory swallowing, and voice quality was preserved at an acceptable level in the majority of cases. Transoral laser microsurgery demonstrated favorable 5-year oncologic outcomes with acceptable functional preservation in selected patients with early-stage glottic cancer. Careful patient selection, preoperative imaging assessment, standardized surgical technique, and intraoperative margin evaluation remain essential for optimizing outcomes.