The Prognostic Factors Of The Early Glottic Carcinoma Treated By Transoral Laser Microsurgery

Objectives:To evaluate the influential factors affecting the prognosis of patient with early glottic carcinoma treated with transoral CO2 laser microsurgery(TLM),and estimate the influence of the orientation of laryngeal invasion on the prognosis of patient with early glottic carcinoma treated by transoral laser microsurgery.Methods:A total of 143 consecutive patients with early glottic carcinoma who underwent TLM from January 2011 to November 2016,consisting of 19 Tis,83 T1a,21 T1b and 20 T2,were retrospectively analyzed.Using the Kaplan-Meier Method to calculate the rate of local control and survives on 1-,3-,and 5-year after transoral laser microsurgery.And utilizing Log-rank Method to exam the association between laryngeal carcinoma recurrence and prognostic variables,namely age,gender,tobacco,drinking,planed further operation,the anterior commissure invasion,vocal process invasion,supraglottic invasion,hypolarynx invasion,vocal muscle invasion,margin status,pathological T stages,differentiated degree,cordectomy types,were analysed.Additionally,the Cox proportional hazard model was used for multivariate analysis.Results:Among the 143 patients with early glottic carcinoma,13 had relapsed and 1 died of liver cancer.The disease-specific survival rate was 100%,100%and 100%in 1 year,3 years and 5 years.And 1-,3-,and 5-year local control rate were 94%,92%,and 87%,respectively.Our study found that age,gender,tobacco,drinking,the anterior commissure invasion,vocal process invasion,supraglottic invasion,vocal muscle invasion,margin status,differentiated degree and cordectomy types,have no effect on prognosis.Pathological T stages,differentiated degree and hypolarynx invasion were the risk factors of recurrence.And hypolarynx invasion is the independent risk factor of the prognosis of patient with early glottic carcinoma treated with transoral C02 laser microsurgery.The risk of postoperative relapse in involving hypolarynx was 13.668 times as not involving hypolarynx.Conclusion:Transoral laser microsurgery is a safe and effective treatment in the early glottic carcinoma.The local control rates were 94%,92%and 87%,respectively,in one year,three years and five years.Tumor extending to the subglottis is more easily relapse than not.If the tranoral laser microsurgery is the best modality for the tumor extending to the subglottis,we should take a prudent attitude.