Abstract
Objective
Recently, the use of laser in head and neck surgery has increased, consequent to technical advances in laser technology and visualization techniques. The objective of this study was to determine survival and qualitative results in patients who have undergone transoral laser excision of base of tongue (BOT) squamous cell carcinoma (SCCA).
Methods
A retrospective chart review was performed of patients with previously untreated, biopsy proven SCCA of the BOT treated with transoral laser excision at a tertiary care facility. All patients had follow-up for at least 24 months. Disease specific and overall survival data was determined using Kaplan-Meier approximations. Quality of life (QOL) data was obtained via interview using a well established questionnaire.
Results
Between 1995 and 2005, 71 patients, ages 38–85, were treated with transoral laser excision for BOT SCCA; 1.4, 12.7, 9.9, and 75% were stage I, II, III, and IV, respectively, at diagnosis. At 24 months, overall survival was 90%, while disease-specific survival was 94%. No correlation was found between survival and gender, overall stage, tumor size, nodal status, or adjuvant therapy. Local-regional recurrence occurred in 10% of patients. QOL data was obtained for 46 patients and yielded acceptable results, with 52% of patients reporting mild or no pain, 98% reporting minimal impairment to normal swallowing, and 70% reporting normal speech.
Conclusions
Transoral laser excision is an innovative method for excision of BOT SCCA and offers an improved approach in terms of survival and quality of life for treatment of these lesions.
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