Surgical Selection And Prognosis Of Early Glottic Laryngeal Carcinoma Involving Anterior Commissure

ObjectiveObjective to evaluate the efficacy of oral CO₂ laser surgery and open surgery in the treatment of early glottic squamous cell carcinoma involving anterior commissure.MethodsThe clinical data of patients with early glottic laryngeal carcinoma receiving CO₂laser surgery and open surgery at Otolaryngology Head and Neck Surgery of Fujian Provincial Hospital from March 1,2008 to March 1,2013 were retrospectively analyzed.According to the situation of the former combined involvement,it can be divided into an earlier combined glottic cancer and an unaffected early glottic cancer.According to the patient’s choice of surgical methods can also be divided into CO₂laser surgery group and open surgery group.After 5 years of follow-up,the patients were selected for surgery,recurrence,and long-term outcome.Results1.The patient’s age ranged from40to90years,T_1a,T_1b,and T₂ glottic laryngeal squamous cell carcinomas had a total of 98 patients,93 men and 5 women during the5 years.Of the 52 patients,46 were not involved in the previous joint.2.The local recurrence rate of early glottic carcinoma after CO₂ laser resection was 19.3%（11/57）,the local control rate was 80.7%（46/57）,and the local recurrence rate after early surgical resection of glottic carcinoma was obtained.It was 9.8%（4/41）and the local control rate was 90.2%（37/41）.3.The difference in the local recurrence rate of the early glottic laryngeal carcinoma between the two types of surgical interventions was statistically significant（Χ²=4.97,P<0.05）.4.There was no significant difference in the local recurrence rate between the two types of surgical treatment before combined with non-affected cases（Χ²=0.56,P>0.05）.5.The local recurrence rate of early glottic carcinoma after CO2 laser resection was higher than that before the unassociated group.The former was 34.8%（8/23）and the latter was 8.8%（3/34）.The difference was statistically significantSignificance（Χ²=5.93,P<0.05）.6.There was no significant difference in postoperative recurrence rate between open surgical resection of early glottic laryngeal carcinoma and the non-involved group（Χ²=0.92,P>0.05）.7.The 5-year survival rate of the two groups was 91.2%（52/57）in the CO₂ laser surgery group and 85.4%（35/41）in the open surgery group.Conclusion1.Open surgery has a lower recurrence rate for early glottic cancer of the larynx involving the forme.2.For the early glottic laryngeal cancer without involvement of the former combination,there was no significant difference in the recurrence rate between the two types of surgery.3.For patients who chose CO2 laser surgery,those who had complications of pre-complications had higher rates of recurrence.4.There was no statistically significant difference in postoperative recurrence rate between patients who had undergone open surgery and those who had previous involvement.