Abstract
Objective: To demonstrate that laryngeal laser resections can be done as day case procedures and the use of frozen section histology negates the need for second look surgery that is recommended by the UK consensus report. Demonstrate patient preference for choice of treatment and comparable outcomes for voice with laser resections.
Method: A retrospective study of patients who underwent laser resection for T1 and T2 laryngeal carcinoma from December 2002 to September 2009 with prospective analysis of functional outcomes and disease-free survival. Suitable patients presenting to the Leeds Head & Neck Cancer Unit were offered a choice between radiotherapy and laser resection.
Results: A total of 60 patients underwent the procedure with greater than 42% patients over the age of 70 years. Ninety percent of patients had intraoperative frozen sections, with concordant histology with final histology in 96%. Forty-two percent of patients had a repeat procedure on average at 10 months of which 36% were recurrence. The number of repeat procedures reduced as our experience for threshold for second look improved with experience. Greater than 50% patients had a single overnight stay for reasons mainly related to geography; a third of patients went home the same day. Greater than 85% of patients had voice that was acceptable or better.
Conclusion: Laryngeal laser resection with frozen section is a valid technique for the treatment of T1 and T2 laryngeal cancer and offers many advantages over radiotherapy. We found that with good pathological support cure can be achieved in a single day case procedure and negates the need for routine second look surgery.
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