Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2018, Vol. 32 ›› Issue (6): 13-17.doi: 10.6040/j.issn.1673-3770.1.2018.025

• Original Articles • Previous Articles     Next Articles

Evaluate the curative effect of CO2 laser in treatment of laryngeal carcinoma

Wenming LI,Dongmin WEI,Ye QIAN,Shengda CAO,Ya XU,Dayu LIU,Xinliang PAN,Dapeng LEI*()   

  1. Department of Otorhinolaryngology, Qilu Hospital of Shandong University, NHC Key Laboratory of Otorhinolaryngology, Jinan 250012, Shandong, China
  • Received:2018-10-15 Online:2018-11-20 Published:2018-11-29
  • Contact: Dapeng LEI E-mail:leidapeng@sdu.edu.cn

RichHTML

1244

PDF (PC)

846

Abstract: Objective

To evaluate the curative effect of CO2 laser in the treatment of laryngeal carcinoma.

Methods

A retrospective analysis of 152 cases of early laryngeal carcinoma treated with laser surgery between 2011 and 2014 was conducted. Among all cases, 11, 102, 31, and 8 were Tis, T1a, T1b, and T2 cases, respectively.

Results

After the CO2 laser treatment, patients were discharged within 1-3 days. There were no complications, such as dyspnea and tracheotomy, during the perioperative period. The long-term pronunciation quality was satisfactory. The follow-up period was 4-8 years. The recurrence rate of glottic carcinoma was 8.2% (147 cases). Two patients had salvage surgery with CO2 laser. Six patients had salvage partial laryngectomy and four cases total laryngectomy. The five-year overall survival rate was 96.6%. Five cases of supraglottic carcinoma were followed up for 5 years without recurrence.

Conclusion

CO2 laser surgery is a minimally invasive, effective, and safe procedure for early laryngeal carcinoma. Satisfactory exposure, good surgical skills, and appropriate surgical indications are fundamental for the success of CO2 laser treatment.

Key words: Laryngeal carcinoma, CO2 laser, Carcinoma, squamous cell

CLC Number: 

  • R767

Fig.1

Flesh plaque hyperplasia and scar evolution after surgery A: Preoperative laryngoscope; B: One month post-surgery, granulation hyperplasia in the operation area can be seen; C: Granulation resolved and scars formed 3-month post-surgery. "

Table 1

Survival rates after laryngeal cancer laser surgery for different stages of tumor[%(n)]"

分期 n 3年生存率 5年生存率
声门型Tis 11 100.0(11/11) 100.0(11/11)
声门型T1a 97 100.0(97/97) 97.9(95/97)
声门型T1b 31 100.0(31/31) 93.5(29/31)
声门型T2 8 100.0(8/8) 87.5(7/8)
声门上型T1 5 100.0(5/5) 100.0(5/5)
合计 152 100.0(152/152) 96.7(147/152)
1 Rosier JF , Grégoire V , Counoy H , et al. Comparison of external radiotherapy, laser microsurgery and partial laryngectomy for the treatment of T1N0M0 glottic carcinomas: a retrospective evaluation[J]. Radiother Oncol, 1998, 48 (2): 175- 183.
doi: 10.1016/S0167-8140(98)00058-9
2 Motta G , Esposito E , Cassiano B , et al. T1-T2-T3 glottic tumors: fifteen years experience with CO2 laser[J]. Acta Otolaryngol Suppl, 1997, (527): 155- 159.
3 Weiss BG , Ihler F , Pilavakis Y , et al. Transoral laser microsurgery for T1b glottic cancer: review of 51 cases[J]. Eur Arch Otorhinolaryngol, 2017, 274 (4): 1997- 2004.
doi: 10.1007/s00405-016-4432-4
4 黄志刚, 韩德民, 于振坤, 等. CO2激光手术治疗声门型喉癌疗效分析[J]. 中华耳鼻咽喉科杂志, 2002, 37 (3): 219- 222.
doi: 10.3760/j.issn:1673-0860.2002.03.017
HUANG Zhigang , HAN Demin , YU Zhenkun , et al. Evaluate the curative effect of CO2 laser in treatment of glottic carcinoma[J]. Chin J Otorhinolaryngol, 2002, 37 (3): 219- 222.
doi: 10.3760/j.issn:1673-0860.2002.03.017
5 周梁, 吴海涛, 黄维庭, 等. CO2激光在声门型喉癌外科治疗中的应用[J]. 中华耳鼻咽喉头颈外科杂志, 2008, 43 (10): 742- 745.
doi: 10.3321/j.issn:1673-0860.2008.10.005
ZHOU Liang , WU Haitao , HUANG Weiting , et al. Treatment of glottic cancer with CO2 laser[J]. Chin J Otorhinolaryngol Head Neck Surg, 2008, 43 (10): 742- 745.
doi: 10.3321/j.issn:1673-0860.2008.10.005
6 黎景佳, 张剑利, 何发尧, 等. 经口CO2激光手术治疗前连合受累的声门型喉癌疗效观察[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52 (5): 337- 342.
doi: 10.3760/cma.j.issn.1673-0860.2017.05.004
LI Jingjia , ZHANG Jianli , HE Fayao , et al. Treatment of glottic cancer involving the anterior commissure by transoral CO2 laser surgery[J]. Chin J Otorhinolaryngol Head Neck Surg, 2017, 52 (5): 337- 342.
doi: 10.3760/cma.j.issn.1673-0860.2017.05.004
7 Shoffel-Havakuk H , Lahav Y , Davidi ES , et al. The role of separate margins sampling in endoscopic laser surgery for early glottic cancer[J]. Acta Otolaryngol, 2016, 136 (5): 491- 496.
doi: 10.3109/00016489.2015.1132843
8 张庆翔, 李平栋, 胡慧英, 等. 累及前连合的早期声门型喉癌经口CO2激光治疗[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50 (4): 286- 289.
doi: 10.3760/cma.j.issn.1673-0860.2015.04.005
ZHANG Qingxiang , LI Pingdong , HU Huiying , et al. Transoral CO2 laser surgery for early glottic carcinoma with anterior commissure involvement[J]. Chin J Otorhinolaryngol Head Neck Surg, 2015, 50 (4): 286- 289.
doi: 10.3760/cma.j.issn.1673-0860.2015.04.005
9 Hoffmann C , Cornu N , Hans S , et al. Early glottic cancer involving the anterior commissure treated by transoral laser cordectomy[J]. Laryngoscope, 2016, 126 (8): 1817- 1822.
doi: 10.1002/lary.25757
10 卢仲明, 宋新汉, 张思毅, 等. 显微喉镜下二氧化碳激光手术治疗喉癌的远期疗效[J]. 中华肿瘤杂志, 2012, 34 (6): 473- 476.
doi: 10.3760/cma.j.issn.0253-3766.2012.06.016
LU Zhongming , SONG Xinhan , ZHANG Siyi , et al. Long-term outcome of CO2 laser microlaryngoscopic treatment for laryngeal cancer[J]. Chin J Oncol, 2012, 34 (6): 473- 476.
doi: 10.3760/cma.j.issn.0253-3766.2012.06.016
11 刘鸣, 田霖丽, 孙亚男, 等. 会厌癌CO2激光显微手术[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48 (6): 490- 494.
doi: 10.3760/cma.j.issn.1673-0860.2013.06.011
LIU Ming , TIAN Linli , SUN Yanan , et al. Transoral CO2 laser epiglottectomy for early epiglottic carcinomas[J]. Chin J Otorhinolaryngol Head Neck Surg, 2013, 48 (6): 490- 494.
doi: 10.3760/cma.j.issn.1673-0860.2013.06.011
12 Pinar E , Calli C , Oncel S , et al. Preoperative clinical prediction of difficult laryngeal exposure in suspension laryngoscopy[J]. Eur Arch Otorhinolaryngol, 2009, 266 (5): 699- 703.
doi: 10.1007/s00405-008-0853-z
13 Bertino G , Degiorgi G , Tinelli C , et al. CO2 laser cordectomy for T1-T2 glottic cancer: oncological and functional long-term results[J]. Eur Arch Otorhinolaryngol, 2015, 272 (9): 2389- 2395.
doi: 10.1007/s00405-015-3629-2
[1] ZHANG Nana, HUANG Guanjiang, LU Biaoqing. Analysis of influencing factors for laryngeal carcinogenesis and construction of a predictive model [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 29-37.
[2] LIU Ping, GU Zijun, CHU Ting, CHEN Xi, CHENG Lei. Effect of high flow respiratory humidification therapy apparatus in patients with artificial airway without mechanical ventilation after laryngeal cancer surgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(5): 31-36.
[3] WEN Feng, ZHANG Chi, HU Xihao, DONG Bingwan, QIN Yong, ZHAO Enmin. Laryngeal adenoid cystic carcinoma: four cases and a literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(4): 119-125.
[4] LI Lijie, TIAN Xiufen. Forty cases of early glottic cancer treated by CO2 laser surgery combined with radiofrequency ablation [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 79-85.
[5] CHEN Guoping, FU Minyi, YE Fei, XU Jianhui. Comparative study of holmium and CO2 laser surgeries for early glottic carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(4): 8-11.
[6] NIU Zijie, XIAO Yang,WANG Jun,MA Lijinng. Progress in the surgical treatment of recurrent laryngeal papillomatosis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(4): 96-100.
[7] SHI Yuqi, SHE Cuiping, ZHANG Qingfeng, LIU Delong, JIAO Mengsi. Experience and lessons of diagnosis and treatment of laryngeal infection after low temperature plasma radiofrequency surgery for early glottic carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(4): 129-134.
[8] ZHOU En, XIAO Yu, XIAO Xuping. Application progress of radiofrequency ablation technology in the treatment of early glottic carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 9-15.
[9] PANG Zhenwen, HUANG Yufeng, YANG Aifang, ZENG Xianjie. Correlation between Preoperative neutrophil/lymphocyte ratio and lymph node metastasis in patients with laryngeal cancer [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 58-62.
[10] TAN Fengwu, DENG Yaping, LI Kehua. The therapeutic effects of low temperature plasma radiofrequency ablation and CO2 laser surgery on early glottic carcinoma: a Meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 63-71.
[11] XU Jinjing, HU Jinghua, WU Yuanqing, DENG Yi, YU Weiwei. Applications of CO2 laser microsurgery on laryngeal precancerous lesions and early glottic laryngeal carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(3): 129-133.
[12] SHEN Min, QU Jining, JIANG Yidao. Evaluation the efficacy of a CO2 laser and traditional exfoliation in the treatment of vocal cord leukoplakia by using objective voice analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 67-70.
[13] Lu LUO,En ZHOU,Si OUYANG,Yi CHEN,Xuping XIAO,Jihua WANG. Expression of the microRNA let-7a in the serum of 42 patients with laryngeal cancer and its significance [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 96-100.
[14] Zhigang HUANG. Treatment of throat tumors with CO2 laser [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(6): 1-3.
[15] Ming LIU. Treatment of epiglottic carcinoma by transoral laser microsurgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(6): 4-7.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd