ENDOSCOPIC HORIZONTAL PARTIAL LARYNGECTOMY BY CO2 LASER IN THE MANAGEMENT OF SUPRAGLOTTIC SQUAMOUS CELL CARCINOMA

Background. The objective of this study was to evaluate the results of endoscopic horizontal supraglottic laryngectomy (EHSL) by CO2 laser. Methods. Between 1996 and 2005, 78 patients underwent a horizontal supraglottic laryngectomy operation (HSL) with an external approach and 70 underwent laser EHSL, as treatment for supraglottic laryngeal squamous cell carcinoma (LSCC). We evaluated oncological endpoints, comparing the external and the endoscopic approach. Results. Among patients primarily treated by EHSL, the 5-year disease-specific survival (DSS) was 89% (vs 80% in the external approach group). Statistical analysis did not reveal significant differences between the 2 groups as for survival nor for organ preservation. The most significant clinical predictor for DSS is neck relapse (p < .0001). Conclusions. This study confirms the effectiveness of laser EHSL in which oncological outcome is similar to the external approach and functional results are probably better. Neck management in this setting is fundamental to warrant the best survival. (C) 2009 Wiley Periodicals, Inc. Head Neck 31: 1196-1206, 2009