Asian Journal of Pharmaceutical Research and Health Care

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Early Outcomes of Transoral Laser Microsurgery for T1-T2 Oropharyngeal Cancer


Affiliations
1 School of Medicine, Vietnam National University - Ho Chi Minh City, Linh Trung Ward, Thu Duc District, Ho Chi Minh City - 700000, Viet Nam
 

The optimal treatment strategy for oropharyngeal carcinoma is highly debated. However, growing evidence supports the use of minimally invasive techniques, such as Transoral Laser Microsurgery (TLM), as a first-line treatment modality for these carcinomas. The purpose of our study was to assess the efficacy and safety of TLM for the treatment of early oropharyngeal carcinomas. This is a prospectively observational study of 30 early stages (T1/T2) oropharyngeal cancer patients who underwent transoral laser microsurgery from January 2016 to March 2019. 30 patients of early-staged oropharyngeal carcinoma (19 tongues, 5 soft palates, 4 tonsils and 2 posterior pharyngeal walls) were included in this study. 19 (63.3%) patients were male and 11 (36.7%) were female. The mean age was 54.8 years (± 10.6 years). 76.7% tumours are T1 and 23.3% T2. The bleeding complications occurred in 2 patients. The most frequent complication of TLM was bleeding. 30% of patients had normal voices and a further 63.3% had only mild or moderate voice change. At their last follow up, no patients had any difficulty in breathing or swallowing. TLM is a safe, minimally invasive and effective method in the treatment for early oropharyngeal cancer.

Keywords

Carbon Dioxide Laser, Oropharyngeal Carcinoma, Transoral Laser Microsurgery.
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  • Steiner W. Laser surgery in the ENT field (laser surgery for the treatment of malignant tumors of the upper aerodigestive tract). Archives of oto-rhino-laryngology Supplement= Archiv fur Ohren-, Nasen-und Kehlkopf Heilkunde Supplement. 1986; 2:8−18.

  • Bahannan AA, ZAbrodsky M, Cerny L, Chovanec M, Lohynska R. Quality of life following endoscopic resection or radio-therapy for early glottic cancer, Saudi Medical Journal. 2007; 28(4):598−602.

  • Hinni ML, Ferlito A, Brandwein‐Gensler MS, Takes RP, Silver CE, Westra WH, et al. Surgical margins in head and neck cancer: A contemporary review, Head and Neck. 2013; 35(9):1362−70. https://doi.org/10.1002/hed.23110. PMid: 22941934.

  • Holsinger FC, McWhorter AJ, Ménard M, Garcia D, Laccourreye O. Transoral lateral oropharyngectomy for squamous cell carcinoma of the tonsillar region: I. Technique, complications, and functional results, Archives of Otolaryngology-Head and Neck Surgery. 2005; 131(7):583−91. https://doi.org/10.1001/archotol.131.7.583. PMid: 16027280.

  • Melong JC, Rigby MH, Bullock M, Hart RD, Trites JR, Taylor SM. Transoral laser microsurgery for the treatment of oropharyngeal cancer: The Dalhousie University experience, Journal of Otolaryngology-Head and Neck Surgery. 2015; 44(1):39. https://doi.org/10.1186/s40463-015-0093-3, https://doi.org/10.1186/s40463-015-0095-1. PMid: 26489752, PMCid: PMC4618864.

  • Wilkie MD, Upile NS, Lau AS, Williams SP, Sheard J, Helliwell TR, et al. Transoral laser microsurgery for oropharyngeal squamous cell carcinoma: A paradigm shift in therapeutic approach, Head and Neck. 2016; 38(8):1263−70. https://doi.org/10.1002/hed.24432. PMid: 27042800.

  • Motta G, Esposito E, Cassiano B, Motta S. T1-T2-T3 glottic tumors: Fifteen years experience with CO2 laser, Acta Oto-laryngologica. 1997; 117(sup527):155−95. https://doi.org/10.3109/00016489709124062.

  • Rudert H, Werner J. Endoscopic resections of glottic and supraglottic carcinomas with the CO2 laser, European Archives of Oto-rhino-laryngology. 1995; 252(3):146−48. https://doi.org/10.1007/BF00178101. PMid: 7662348.

  • Peretti G, Cappiello J, Nicolai P, Smussi C, Antonelli AR. Endoscopic laser excisional biopsy for selected glottic carcinomas, The Laryngoscope. 1994; 104(10):1276−79. https://doi.org/10.1288/00005537-199410000-00017. PMid: 7934601.

  • Cohen SM, Garrett CG, Dupont WD, Ossoff RH, Courey MS. Voice-related quality of life in T1 glottic cancer: irradiation versus endoscopic excision, Annals of Otology, Rhinology and Laryngology. 2006; 115(8):581−86. https://doi.org/10.1177/000348940611500803. PMid: 16944656.

  • Weinstein GS, Quon H, O’Malley Jr BW, Kim GG, Cohen MA. Selective neck dissection and deintensified postoperative radiation and chemotherapy for oropharyngeal cancer: A subset analysis of the University of Pennsylvania transoral robotic surgery trial, The Laryngoscope. 2010; 120(9):1749−55. https://doi.org/10.1002/lary.21021. PMid: 20717944.

  • Grant DG, Hinni ML, Salassa JR, Perry WC, Hayden RE, Casler JD. Oropharyngeal cancer: A case for single modality treatment with transoral laser microsurgery, Archives of Otolaryngology-Head and Neck Surgery. 2009; 135(12):1225−30. https://doi.org/10.1001/archoto.2009.185. PMid: 20026820.

  • Thomas L, Jones TM, Tandon S, Carding P, Lowe D, Rogers S. Speech and voice outcomes in oropharyngeal cancer and evaluation of the University of Washington Quality of Life speech domain, Clinical Otolaryngology. 2009; 34(1):34−42. https://doi.org/10.1111/j.1749-4486.2008.01830.x. PMid: 19260883.

  • Kennedy J, Paddle P, Cook B, Chapman P, Iseli T. Voice outcomes following transoral laser microsurgery for early glottic squamous cell carcinoma, The Journal of Laryngology and Otology. 2007; 121(12):1184−88. https://doi.org/10.1017/S0022215107007554. PMid: 17445355.

  • Haughey BH, Hinni ML, Salassa JR, Hayden RE, Grant DG, Rich JT, et al. Transoral laser microsurgery as primary treatment for advanced‐stage oropharyngeal cancer: A United States multicenter study, Head and Neck. 2011; 33(12):1683−94. https://doi.org/10.1002/hed.21669. PMid: 21284056.

  • Canis M, Martin A, Kron M, Konstantinou A, Ihler F, Wolff HA, et al. Results of transoral laser microsurgery in 102 patients with squamous cell carcinoma of the tonsil, European Archives of Oto-rhino-laryngology. 2013; 270(8):2299−306. https://doi.org/10.1007/s00405-012-2335-6, https://doi.org/10.1007/s00405-012-2327-6. PMCid: PMC3699705.

  • Ansarin M, Santoro L, Cattaneo A, Massaro MA, Calabrese L, Giugliano G, et al. Laser surgery for early glottic cancer: impact of margin status on local control and organ preservation, Archives of Otolaryngology-Head and Neck Surgery. 2009; 135(4):385−90. https://doi.org/10.1001/archoto.2009.10. PMid: 19380362.


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  • Early Outcomes of Transoral Laser Microsurgery for T1-T2 Oropharyngeal Cancer

Abstract Views: 412  |  PDF Views: 233

Authors

Tran Phan Chung Thuy
School of Medicine, Vietnam National University - Ho Chi Minh City, Linh Trung Ward, Thu Duc District, Ho Chi Minh City - 700000, Viet Nam
Nguyen Thanh Tuan
School of Medicine, Vietnam National University - Ho Chi Minh City, Linh Trung Ward, Thu Duc District, Ho Chi Minh City - 700000, Viet Nam

Abstract


The optimal treatment strategy for oropharyngeal carcinoma is highly debated. However, growing evidence supports the use of minimally invasive techniques, such as Transoral Laser Microsurgery (TLM), as a first-line treatment modality for these carcinomas. The purpose of our study was to assess the efficacy and safety of TLM for the treatment of early oropharyngeal carcinomas. This is a prospectively observational study of 30 early stages (T1/T2) oropharyngeal cancer patients who underwent transoral laser microsurgery from January 2016 to March 2019. 30 patients of early-staged oropharyngeal carcinoma (19 tongues, 5 soft palates, 4 tonsils and 2 posterior pharyngeal walls) were included in this study. 19 (63.3%) patients were male and 11 (36.7%) were female. The mean age was 54.8 years (± 10.6 years). 76.7% tumours are T1 and 23.3% T2. The bleeding complications occurred in 2 patients. The most frequent complication of TLM was bleeding. 30% of patients had normal voices and a further 63.3% had only mild or moderate voice change. At their last follow up, no patients had any difficulty in breathing or swallowing. TLM is a safe, minimally invasive and effective method in the treatment for early oropharyngeal cancer.

Keywords


Carbon Dioxide Laser, Oropharyngeal Carcinoma, Transoral Laser Microsurgery.

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DOI: https://doi.org/10.18311/ajprhc%2F2018%2F23526