Prognostic role of margin status in open and CO2 laser cordectomy for T1a-T1b glottic cancer.

INTRODUCTION: Cordectomy by laringofissure and transoral laser surgery has been proposed for the treatment of early glottic cancer.

OBJECTIVES: The aim of this retrospective study was to evaluate the prognostic value of margin status in 162 consecutive cases of early glottic carcinoma (Tis-T1) treated with CO2 laser endoscopic surgery (Group A) or laryngofissure cordectomy (Group B), and to compare the oncologic and functional results.

METHODS: Clinical prognostic factors, local recurrence rate according to margin status, overall survival and disease-free survival were analyzed.

RESULTS: Margin status is related to recurrence rate in both groups (p<0.05) without significant differences between open and laser cordectomy (p>0.05). The 5 years overall survival and disease-free survival were respectively 90.48% and 85.71% in Group A; 88.14% and 86.44% in Group B (p>0.05). Lower tracheostomy rate, earlier recovery of swallowing function and shorter hospital stay were observed in Group A (p<0.05).

CONCLUSIONS: Margin status has a prognostic role in T1a-T1b glottic cancer. Transoral laser surgery showed similar oncologic results of open cordectomy, with better functional outcomes.