Potential role of transoral laser surgery for larynx carcinoma

Background and Objective: The treatment of larynx carcinoma is not settled to date. This prospective study evaluates the potential role of transoral laser surgery (TLS) for larynx carcinoma in a large series of unselected patients from a single institution. Materials and Methods A total of 504 consecutive patients with previously untreated carcinoma of the larynx were seen from 1986–1994. Their treatment modalities and results were prospectively evaluated. Results TLS was used in 290 patients (58%), total laryngectomy in 130 (26%), conventional partial laryngectomies in 31 (6%), and radiotherapy in 34 (7%). Nineteen (4%) had no curative treatment. Uncorrected actuarial survival for all patients with glottic carcinoma stages I and II treated with laser surgery (n = 202) was 80.2%, cause specific survival 96.7%, and local control 85.8%. Uncorrected actuarial survival for all patients with supraglottic carcinoma stages I and II treated with laser surgery (n = 40) was 49.0%, cause specific survival 78.6%, and local control 87.3%. Conclusion TLS was the most important single treatment modality in this large series of unselected patients. It is a safe and time‐ and cost‐effective alternative to radiotherapy for early stage larynx carcinoma. Lasers Surg. Med. 23:79–86, 1998. © 1998 Wiley‐Liss, Inc.