Endoscopic CO2 laser surgery for supraglottic cancer - ten years of experience [Naše 10-godišnje iskustvo u endoskopskom kirurškom liječenju supraglotičkih karcinom pomoću CO2 lasera]

Bumber, Željko and Prgomet, Drago and Janjanin, Saša (2009) Endoscopic CO2 laser surgery for supraglottic cancer - ten years of experience [Naše 10-godišnje iskustvo u endoskopskom kirurškom liječenju supraglotičkih karcinom pomoću CO2 lasera]. Collegium antropologicum, 33 (1). pp. 87-91. ISSN 0350-6134

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Abstract

We present our experience with primary CO2 laser surgery for planocellular supraglottic carcinoma. During a ten-year period, we performed 64 curative supraglottic laryngectomies. Twenty-nine patients presented with T1 and 35 with T2 carcinoma. There were 46 patients without regional and/or distant metastases (N0 neck), and 18 patients with N+ neck. Thirty-three (52%) patients were treated with surgery alone, and in 31 (48%) patients surgical procedure was combined with radiotherapy. Estimated overall 5-year survival for all patients was 89%. Local and regional tumor control as well as survival rate were comparable with the results of other therapeutic options, i.e. radiotherapy or open supraglottic laryngectomy. Functional results outline the advantages of endoscopic laser surgery for laryngeal carcinoma. Transoral endoscopic CO2 laser surgery is efficacious treatment for T1 and T2 supraglottic carcinoma, and can be combined with neck dissection and postoperative irradiation.

Abstract in Croatian

U radu smo opisali naše iskustvo u kirurškom liječenju primarnih supraglotičkih karcinoma pomoću CO2 lasera. U razdoblju od 10 godina u 64 bolesnika je urađena kurativna endoskopska supraglotička laringektomija. 29 bolesnika imalo je T1, a 35 bolesnika T2 lezije grkljana. 46 bolesnika nije imalo regionalne niti udaljene metastaze (N0 vrat), dok je 18 bolesnika imalo metastatske promjene u vratu (N+ vrat). 33 (52%) bolesnika liječena su samo kirurški, dok je kod 31 (48%) bolesnika kirurško liječenje nadopunjeno radioterapijom. Očekivano 5-godišnje preživljenje za sve bolesnike iznosilo je 89%. Lokalna i regionalna kontrola tumora, kao i stopa preživljenja u naših bolesnika može se usporediti s ishodima drugih vrsta terapije ove bolesti, poput primarne iradijacije ili otvorene supraglotičke laringektomije. Prednost endoskopske laserske kirurgije grkljana nad ostalim metodama je u dobrim funkcijskim rezultatima. Transoralna endoskopska kirurgija CO2 laserom je učinkovita u liječenju T1 i T2 supraglotičnih tumora grkljana i može se kombinirati s disekcijom vrata i postoperativnim zračenjem.

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