Application of radiofrequency ablation with plasma spot excitation in early glottic carcinoma(Tis-T1b)
- XIAO Xuping, ZHOU En, XIAO Yu
Journal of Otolaryngology and Ophthalmology of Shandong University. 2021, 35(2):
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Objective This study aimed to evaluate the efficacy of radiofrequency coblation(RFC)in the treatment of early glottic carcinoma(Tis-T1b). Methods A total of 58 patients with early glottic carcinoma(Tis-T1b)at People's Hospital were enrolled from October 2018 to April 2020. All patients were men. According to the surgical method, 31 and 27 patients were included in the RFC and CO2 laser groups, respectively. The average patient age was 52.1±8.7 and 55.6±10.3 years in the RFC and CO2 laser groups, respectively. In the RFC group, the tumor-node-metastasis(TNM)stage was Tis, T1a, and T1b in 6, 23, and 2 patients, respectively, while in the CO2 laser surgery group, the TNM stage was Tis, T1a, and T1b in 3, 22, and 2 patients, respectively. All patients were followed up for 6-18 months, and the operation time, postoperative pain score, and cough score were recorded. All patients underwent reassessment at 1, 3, and 6 months after surgery using an electronic laryngoscope. Results The operation time was shorter in the RFC group than in CO2 laser group(11.81 vs. 16.77 min, P<0.001). There were no significant differences in the length of hospital stay, blood loss, pain score, cough score, anterior conglutination rate, and granulomatous hyperplasia between the groups(P=0.676,0.390,0.483,0.483,0.094,0.788). All patients were followed up in the outpatient department. No deaths occurred during the follow-up period. Four patients developed local recurrence, including 2 patients(1 patient with T1b involving anterior commissure and 1 patient with T1a)in the RFC group and 2 patients(2 patients with T1b involving anterior commissure)in the CO2 laser group. Both patients in the RFC group underwent repeat plasma surgery and 1 patient in the CO2 laser group underwent CO2 laser extended resection. In one patient with unilateral cervical lymph node metastasis, the surgery was converted to open surgery. There was no significant difference in the local recurrence rate between the groups(P=0.276). The acoustic parameters of Jitter, Shimer, and NHR recovered gradually in all patients at different time points postoperatively(P<0.05), and the acoustic parameters of the RFC group were better than those of the CO2 laser group(P=0.000,0.001,0.000). Conclusion Radiofrequency ablation with the plasma spot excitation technique is safe and effective for the treatment of early glottic carcinoma(Tis-T1b). It has the advantages of short operation time, small mucosal injury, and good preservation of voice function. However, the long-term tumor control rate and survival rate need to be further observed.