Clinical Outcome of Supraglottic Laryngectomy in Supraglottic Cancer : Open vs Transoral Laser Supraglottic Laryngectomy

Chang, Jiwon; Jang, Minhee; Jung, Eun Jae; Baek, Seung Kuk; Kwan, Soon Young; Woo, Jeong Soo; Jung, Kwang Yoon

Abstract

BACKGROUND AND OBJECTIVES: When treating the supraglottic cancer, we must consider functions such as respiration, phonation, swallowing, aspiration as well as the complete eradication of the disease. Open supraglottic laryngectomy is an oncologically safe procedure that can preserve the laryngeal function. However, in immediate perioperative time, supraglottic laryngectomy requires tracheostomy and L-tube insertion. On the other hand, transoral laser supraglottic laryngectomy, while it is debated whether or not it is oncologically safe, it doesn't require tracheostomy and L-tube insertion. We compared and analyzed the outcomes and morbidity of both treatments.
SUBJECTS AND METHOD
Patients who have been diagnosed as supraglottic cancer between January 1995 through December 2004 and who were treated with either open supraglottic laryngectomy or transoral laser supraglottic laryngectomy for the primary treatment were included in the study. We analyzed the overall survival and treatment results through retrospective chart review and the statistical analysis was carried out by the SPSS 10.0.
RESULTS
Five-year overall survival rate was 88.5% in open surgery and 78.2% in transoral surgery. But the p-value of 0.216 indicates that there is no statistically significant differences among two groups. Five-year disease free survival rates were 83.4% in open surgery and 68.0% in transoral surgery. The p-value of 0.221 again indicates that there is no statistically significant differences among two groups. Tracheostomy and L-tube insertion were conducted in all of the patients in open surgery but conducted in 20% and 6.7% of the patients, respectively, in transoral surgery.
CONCLUSION
There are no differences between the 5-year overall survival rate and 5-year disease free survival rate between the two groups. However, morbidity is lower in the transoral group, so it would be preferable to conduct transoral laser supraglottic laryngectomy in supraglottic cancer patients in the future. Further studies using more cases are recommended.