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Casanueva R, López F, García-Cabo P, Álvarez-Marcos C, Llorente JL, Rodrigo JP. Oncological and functional outcomes of transoral laser surgery for hypopharyngeal carcinoma. Eur Arch Otorhinolaryngol 2023; 280:829-837. [PMID: 36056169 PMCID: PMC9849286 DOI: 10.1007/s00405-022-07622-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/16/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Surgical resection or radiotherapy (RT) are standard approaches for early-staged hypopharyngeal squamous cell carcinoma (HPSCC). Transoral laser microsurgery (TOLMS) seems to provide good oncological and functional results with few local complications. The aim of our study was to analyze the outcomes of TOLMS, with or without neck dissection or RT, in the treatment of HPSCC in a tertiary referral center. METHODS A retrospective study was conducted in patients with early T-category (T1-T2) HPSCC treated by TOLMS. RESULTS A total of 34 patients were included in the study. The series includes 17 (50%) T1 and 17 (50%) T2 classified tumors. The 5-year overall survival and disease-specific survival rates were 51% and 66%, respectively, with a 5-year local control rate of 92%. All patients reassumed oral diet and none of them had a tracheostomy at the end of the follow-up. CONCLUSIONS TOLMS offers an effective treatment option in terms of oncologic control and function preservation in locally circumscribed HPSCC.
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Affiliation(s)
- Rodrigo Casanueva
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Avenida de Roma, s/n, 33011, Oviedo, Spain
| | - Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Avenida de Roma, s/n, 33011, Oviedo, Spain.
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Madrid, Spain.
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain.
| | - Patricia García-Cabo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Avenida de Roma, s/n, 33011, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Madrid, Spain
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | - César Álvarez-Marcos
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Avenida de Roma, s/n, 33011, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Madrid, Spain
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | - José Luis Llorente
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Avenida de Roma, s/n, 33011, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Madrid, Spain
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | - Juan Pablo Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Avenida de Roma, s/n, 33011, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Madrid, Spain
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
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Zhao J, Li J. Coblation-assisted transoral supraglottic laryngectomy. EAR, NOSE & THROAT JOURNAL 2022:1455613221107686. [PMID: 35786060 DOI: 10.1177/01455613221107686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Transoral supraglottic laryngectomy (TSL) has been widely applied in the treatment of supraglottic cancers. The aim of this study is to evaluate a simplified technique for excising properly selected supraglottic tumors with a transoral coblation-assisted system. METHODS Eight patients with T1-3N2M0 supraglottic cancer were treated with TSL with the coblation-assisted system. RESULTS Tumors in all patients were en bloc resected with negative surgical margins and the selective neck dissection was also performed. The mean operation time for TSL was 39 minutes (25-65 minutes). The average time for the removal of the nasogastric tube was 8.6 days (1-28 days). All patients were extubated and shifted to the ward after operation. None of the patients required tracheotomy. CONCLUSION Coblation-assisted TSL is a relatively simple, easy approach with low risk. It could be a feasible and safe procedure for patients with properly selected supraglottic cancer.
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Affiliation(s)
- Jing Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Jinrang Li
- Department of Otorhinolaryngology Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China
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Wang CC, Lin WJ, Liu YC, Chen CC, Wu SH, Liu SA, Liang KL. Transoral Robotic Surgery for Pharyngeal and Laryngeal Cancers-A Prospective Medium-Term Study. J Clin Med 2021; 10:jcm10050967. [PMID: 33801167 PMCID: PMC7957508 DOI: 10.3390/jcm10050967] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 01/13/2023] Open
Abstract
Transoral robotic surgery (TORS) has been used for treating pharyngeal and laryngeal cancers for many years. However, the application of neoadjuvant chemotherapy (NACT) before TORS, the sparing rate of adjuvant irradiation after TORS, and the long-term oncologic/functional outcomes of TORS are seldom reported. From September 2014 to May 2018, 30 patients with clinical T1 to T3 cancers of oropharynx (7), larynx (3), and hypopharynx (20) were prospectively recruited for TORS in a tertiary referral medical center. Twelve (40%) patients had clinical early stage (I or II) disease, and 18 (60%) patients had late-stage (III or IV) disease. All 30 patients were suggested to receive TORS with neck dissection. Cisplatin-based NACT was given to 11 patients before the surgery, and it led to a 100% reduction in tumor size. Only 40% of patients needed adjuvant irradiation with a mean dosage of 5933 cGY after TORS. After a mean follow up of 38.9± 14.7 months, the Kaplan-Meier method estimated 5-year disease-specific survival, and organ preservation was 86.3% and 96.2%, respectively. Twenty-five patients were alive without tracheostomy and tube feeding. We found that NACT is a potential method for facilitating tumor resection and TORS effectively de-escalated adjuvant irradiation with a satisfactory 5-year survival and functional outcomes.
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Affiliation(s)
- Chen-Chi Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (Y.-C.L.); (S.-A.L.); (K.-L.L.)
- School of Speech Language Pathology & Audiology, Chung Shan Medical University, Taichung 40121, Taiwan
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung 41354, Taiwan
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (W.-J.L.); (S.-H.W.)
- Correspondence: ; Tel.: +886-4-23592525 (ext. 83601)
| | - Wen-Jiun Lin
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (W.-J.L.); (S.-H.W.)
| | - Yi-Chun Liu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (Y.-C.L.); (S.-A.L.); (K.-L.L.)
- Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Chien-Chih Chen
- Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
- Ph. D. Program in Translational Medicine, National Chung-Hsing University, Taichung 40227, Taiwan
| | - Shang-Heng Wu
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (W.-J.L.); (S.-H.W.)
| | - Shih-An Liu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (Y.-C.L.); (S.-A.L.); (K.-L.L.)
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (W.-J.L.); (S.-H.W.)
| | - Kai-Li Liang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (Y.-C.L.); (S.-A.L.); (K.-L.L.)
- Department of Otolaryngology-Head & Neck Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (W.-J.L.); (S.-H.W.)
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Hanna J, Brauer PR, Morse E, Mehra S. Margins in Laryngeal Squamous Cell Carcinoma Treated with Transoral Laser Microsurgery: A National Database Study. Otolaryngol Head Neck Surg 2019; 161:986-992. [DOI: 10.1177/0194599819874315] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objectives To determine national positive margin rates in transoral laser microsurgery, to compare patients with positive and negative margins, and to identify factors associated with positive margins. Study Design Retrospective review of the National Cancer Database. Setting Population based. Subjects/Methods Patients included those with TIS-T3 laryngeal squamous cell carcinoma (2004-2014). Univariable and multivariable logistic regression were used to identify predictors. Results A total of 1959 patients met inclusion criteria. The national positive margin rate was 22.3%. Sixty-five percent of patients had T1 disease; 94.3% were N-negative; and 74.0% had glottic tumors. Fifty-eight percent of patients were treated at academic centers, and 60.6% were treated at facilities performing <2 cases per year. On multivariable analysis, factors associated with margin status included facility volume (odds ratio [95% CI]; in cases per year: 0.93 [0.89-0.97], P = .001), academic status (vs nonacademic; academic: 0.70 [0.54-0.90], P = .008), T-stage (vs T1; T2: 2.74 [2.05-3.65], T3: 5.53 [3.55-8.63], TIS: 0.59 [0.38-0.92], P < .001), and N-stage (vs N0; N1: 3.42 [1.79-6.54], N2: 2.01 [1.09-3.69], P < .001). Tumor subsite was not associated with margin status. Conclusion The national positive margin rate for laryngeal laser surgery is 22%, which is concerning given the equivalent survival benefit offered by surgery and primary radiation and the increased likelihood of bimodal therapy in the situation of positive margins. Cases treated at nonacademic centers and those with lower caseloads had a higher likelihood of positive margins. There was a linear association between T-stage and likelihood of positive margins, with T3 tumors being 5 times as likely as T1 to yield positive margins. This study highlights the importance of proper patient selection for transoral laser microsurgery resections.
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Affiliation(s)
- Jonathan Hanna
- Section of Otolaryngology, Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Philip R. Brauer
- Section of Otolaryngology, Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Elliot Morse
- Section of Otolaryngology, Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Saral Mehra
- Section of Otolaryngology, Department of Surgery, School of Medicine, Yale University, Yale–New Haven Hospital, Yale Cancer Center, New Haven, Connecticut, USA
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Abstract
Successful management of laryngeal cancer depends on careful pretreatment evaluation of patient and disease factors to arrive at accurate staging, leading to appropriate treatment selection for patients with this highly impacting disease. Surgical modalities, including transoral laser microsurgery, open partial laryngectomy, and total laryngectomy, offer options, alone or in combination with radiation and chemotherapy. Treatment strategy for laryngeal cancer should strive for cure while maintaining the best quality of life possible for the patient. Achieving the goals of initial and salvage treatment for laryngeal cancer depends on executing a plan of care determined by the expertise of the multidisciplinary team.
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Rodrigo JP, García‐Velasco F, Ambrosch P, Vander Poorten V, Suárez C, Coca‐Pelaz A, Strojan P, Hutcheson K, Folz BJ, Bernal‐Sprekelsen M, Rinaldo A, Silver CE, Ferlito A. Transoral laser microsurgery for glottic cancer in the elderly: Efficacy and safety. Head Neck 2019; 41:1816-1823. [DOI: 10.1002/hed.25616] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/25/2018] [Accepted: 12/11/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Juan P. Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de AsturiasUniversity of Oviedo, ISPA, IUOPA, CIBERONC Oviedo Spain
| | - Fabian García‐Velasco
- Department of Otolaryngology, Hospital Universitario Central de AsturiasUniversity of Oviedo, ISPA, IUOPA, CIBERONC Oviedo Spain
| | - Petra Ambrosch
- Department of Otorhinolaryngology, Head and Neck SurgeryChristian‐Albrechts‐University of Kiel Kiel Germany
| | - Vincent Vander Poorten
- Otorhinolaryngology, Head and Neck SurgeryUniversity Hospitals Leuven Leuven Belgium
- Department of Oncology, Section Head and Neck OncologyKU Leuven Leuven Belgium
| | - Carlos Suárez
- Department of Otolaryngology, Hospital Universitario Central de AsturiasUniversity of Oviedo, ISPA, IUOPA, CIBERONC Oviedo Spain
| | - Andrés Coca‐Pelaz
- Department of Otolaryngology, Hospital Universitario Central de AsturiasUniversity of Oviedo, ISPA, IUOPA, CIBERONC Oviedo Spain
| | - Primoz Strojan
- Department of Radiation OncologyInstitute of Oncology Ljubljana Slovenia
| | - Kate Hutcheson
- Department of Head and Neck Surgery, Section of Speech Pathology and AudiologyMD Anderson Cancer Center Houston Texas
| | | | | | - Alessandra Rinaldo
- Otorhinolaryngology‐Head and neck surgery, University of Udine School of Medicine Udine Italy
| | - Carl E. Silver
- Department of SurgeryUniversity of Arizona College of Medicine Phoenix Arizona
| | - Alfio Ferlito
- International Head and Neck Scientific Group Padua Italy
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Oncological and functional outcomes of transoral laser surgery for laryngeal carcinoma. Eur Arch Otorhinolaryngol 2018; 275:2071-2077. [PMID: 29869708 DOI: 10.1007/s00405-018-5027-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 05/29/2018] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Transoral laser microsurgery (TLM) has become the standard approach for treatment of early-stage laryngeal carcinoma in most institutions due to their good oncological and functional results with few local complications. The purpose of this study was to analyze the oncological and functional results of TLM in the treatment of laryngeal tumors at our Hospital. MATERIALS AND METHODS Patients with laryngeal squamous cell carcinoma (LSCC) treated from 1998 to 2013 with TLM with curative intention, and with a minimum follow-up of 24 months, were reviewed. RESULTS 203 patients with LSCC were included. 195 patients were men (96%) and 8 women (4%), with a mean age of 63 years. The series includes 134 (66%) T1, 40 (20%) T2, and 29 (14%) T3-classified tumors. 116 tumors (57%) were in the glottis, 79 (39%) in the supraglottis and 8 (4%) in the anterior commissure. 16 patients (8%) received adjuvant radiotherapy. Initial local control was obtained in 75.5% of patients. The 5-year overall survival rate was 84% and the 5-year disease-specific survival was 90%. The presence of nodal metastasis (p < 0.001) and the involvement of the surgical margins (p = 0.004) were associated with a lower disease-specific survival in the multivariate analysis. All but three patients with local control of the disease reassumed oral diet, and none were tracheostomy-dependent. The 5-year laryngeal preservation rate was 85%. CONCLUSIONS TLM is a minimally invasive treatment for early and moderately-advanced laryngeal carcinomas, with good oncologic and functional outcomes, and few complications as well.
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Breda E, Catarino R, Monteiro E. Transoral laser microsurgery as standard approach to hypopharyngeal cancer survival analysis in a hospital based population. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018. [DOI: 10.1016/j.otoeng.2016.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Breda E, Catarino R, Monteiro E. Transoral laser microsurgery as standard approach to hypopharyngeal cancer. Survival analysis in a hospital based population. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 69:1-7. [PMID: 28190450 DOI: 10.1016/j.otorri.2016.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 11/10/2016] [Accepted: 11/13/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Cancer of the hypopharynx remains one of the most challenging chapters in head and neck oncology. The objective of this study is to ascertain the relevance of a transoral laser approach as a valid functional option for treatment of cancer of the hypopharynx in Portugal, and additionally, to confirm the reproducibility of survival and functional outcomes described in other reference centers. SUBJECTS AND METHODS The outcomes of 37 out of 60 patients presenting hypopharyngeal carcinoma primarily treated by TLM (transoral laser microsurgery) and neck dissection and or adjuvant treatment when needed, with curative intention in tertiary referral center, were retrospectively evaluated and compared with published results. RESULTS There were no patients in stage I. Three-year and five-year overall survival (Kaplan-Meier) were 83.5% and 63.5% for stage II (n=12), 57.1% (only 3-year overall survival evaluable for this stage) for stage III (n=7), and 53.1% and 39.8% for stage IVa (n=18), respectively. Five-year local control rates were 90% for stage II and 87.5% for stage IVa, respectively; only three-year local control rates were possible to evaluate for stage III, with a 100% control rate. Five-year total larynx preservation rate was 97.3%. CONCLUSIONS TLM, alone or with neck dissection and adjuvant therapy, is a valid procedure for treatment of hypopharyngeal cancer in different stages. Furthermore, this kind of approach can be replicated in different oncologic centers with similar oncologic and functional results.
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Affiliation(s)
- Eduardo Breda
- Department of Otolaryngology, Portuguese Institute of Oncology Dr Francisco Gentil, Porto, Portugal.
| | - Raquel Catarino
- Molecular Oncology GRP CI, Portuguese Institute of Oncology Dr Francisco Gentil, Porto, Portugal
| | - Eurico Monteiro
- Department of Otolaryngology, Portuguese Institute of Oncology Dr Francisco Gentil, Porto, Portugal
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Tomifuji M, Araki K, Yamashita T, Shiotani A. Salvage Transoral Videolaryngoscopic Surgery for radiorecurrent hypopharyngeal and supraglottic cancer. Auris Nasus Larynx 2016; 44:464-471. [PMID: 27856033 DOI: 10.1016/j.anl.2016.10.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/16/2016] [Accepted: 10/19/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate the feasibility of Transoral Videolaryngoscopic Surgery (TOVS) for radiorecurrent supraglottic and hypopharyngeal cancer, and to compare survival and complications between primary and radiorecurrent cases. METHODS Twelve cases of salvage TOVS for radiorecurrent cancer and 53 cases of TOVS as an initial treatment (primary cases) were evaluated. Days to resume soft diet, Functional Outcomes of Swallowing Scale (FOSS), postoperative complications, epithelization days and survival outcomes were assessed by retrospective chart review. RESULTS FOSS score was significantly worse in salvage cases compared with primary cases. Bleeding and airway compromise was slightly greater in salvage cases than in primary cases; however, this was not statistically significant. Wound healing was significantly delayed in salvage cases compared with primary cases (P<0.001). In primary cases, wounds were re-epithelized within 60 days in 83% of patients and within 90 days in almost all patients, while in salvage cases 42% of patients required more than 90 days for wound healing. In salvage cases, the 5-year overall survival, disease specific survival rate, local control rate, and laryngeal preservation rate was 85.7%, 85.7%, 62.5%, and 78.0%, respectively, and 85.7%, 98.0%, 91.3%, and 97.8%, respectively, for primary cases. Local control rate was significantly better in primary cases than in salvage cases. CONCLUSION Salvage TOVS was feasible in highly selected cases. After serial transoral surgery, the final laryngeal preservation rate was satisfactory. Swallowing function in salvage cases tended to be worse than in primary cases, and a significantly longer time was required for wound healing.
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Affiliation(s)
- Masayuki Tomifuji
- National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan.
| | - Koji Araki
- National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan
| | - Taku Yamashita
- Kitasato University School of Medicine, Department of Otorhinolaryngology - Head and Neck Surgery, Kanagawa, Japan
| | - Akihiro Shiotani
- National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan
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Clinical significance of granulation tissue after transoral laser microsurgery for glottic cancer. The Journal of Laryngology & Otology 2015; 129:377-82. [DOI: 10.1017/s0022215115000444] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:Granulation tissue after transoral laser microsurgery can make it difficult to distinguish between normal healing and tumour recurrence.Materials and methods:We carried out a retrospective analysis of 316 consecutive glottic carcinomas (Tis–T3). Presence of granulation tissue at one and six months was correlated with demographic and clinical data, tumour and surgical characteristics, and tumour relapse.Results:Granulation tissue appeared in 53.8 per cent of patients at month 1, resolving spontaneously in 41.8 per cent. Revision surgery was performed in 60.1 per cent and was effective in 41.1 per cent. At month 6, 14.9 per cent of patients presented with granulation tissue. In 74.5 per cent the tissue was surgically removed and was positive for malignancy in 62.9 per cent. Tumour relapse presented in 29.4 per cent with granulation tissue at month 1 and in 61.7 per cent at month 6 (p= 0.000). Granulation tissue at month 1 correlated with thyroid cartilage exposure and continued smoking. At month 6, granulation tissue correlated with thyroid cartilage exposure, the affected surgical margins and diabetes.Conclusion:Granulation tissue after transoral laser microsurgery is frequent. When it persists at six months, revision surgery is formally recommended.
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Schoob A, Kundrat D, Kleingrothe L, Kahrs LA, Andreff N, Ortmaier T. Tissue surface information for intraoperative incision planning and focus adjustment in laser surgery. Int J Comput Assist Radiol Surg 2014; 10:171-81. [DOI: 10.1007/s11548-014-1077-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 05/16/2014] [Indexed: 12/01/2022]
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