Endoscopic treatment of cis-T2 glottic cancer with a CO(2) laser: preliminary results from a Canadian centre.

Abstract

In Canada, endoscopic resection using a CO(2) laser has been generally ignored as a treatment option. In this article, we present an introductory analysis of our clinical experience with the CO(2) laser at the QEII Health Sciences Centre in Halifax, Nova Scotia. Outcomes from a cohort of 36 patients with glottic cancer staged as Cis-T2 (7 Cis, 17 T1, 12 T2) who underwent endoscopic resection using a CO(2) laser between January 2002 and June 2005 were studied retrospectively. The mean follow-up was 16.2 months (range 0-41 months). At the time of the study, no patient had died of laryngeal disease, one patient had died of another disease, and one patient was lost to follow-up. There had been three recurrences in the cohort: two local recurrences and one recurrence in a regional lymph node. After salvage, all patients with recurrences were disease free at the time of the study. There were three postoperative complications in the cohort: one postoperative myocardial infarction, one case of respiratory distress postextubation, and one case of subcutaneous emphysema. The average time for the procedure was 0.97 hours (range 0.25-2.75 hours). The average postoperative length of stay was 1.2 days (range 0-12 days). Of 35 cases with follow-up, 60% had no reported problems with voice in their last visit and 11% reported consistent hoarseness or weakness. Although our oncologic results do require more follow-up, based on our positive experience thus far, we believe that endoscopic management of glottic cancer is a treatment option that may be underused in the Canadian health care system.