COMPARISON OF EXTERNAL RADIOTHERAPY, LASER MICROSURGERY AND PARTIAL LARYNGECTOMY FOR THE TREATMENT OF T1NOMO GLOTTIC CARCINOMAS - A RETROSPECTIVE EVALUATION

Purpose: The aim of this study was to retrospectively compare the effi cacy and functional results of three treatment options for T1N0M0 glot tic carcinomas applied in a single institution. Materials and methods: One hundred six charts of patients with biopsy-proven T1N0M0 glottic carcinomas treated between 1979 and 1995 were reviewed. There were 81 T1a and 25 T1b tumors. Forty-one patients were treated by radiotherapy (RT) (median dose of 64 Gy), 34 patients were treated by partial lary ngectomy (PL) and 31 patients were treated by laser microsurgery (L) o f which 10 received postoperative RT for positive margins. In 18 patie nts, a perceptual voice rating on a visual scale was performed by the patients themselves, three non-speech specialists and-two speech thera pists. Results: With a median follow-up time of 63.5 months, the 5- an d 10-year loco-regional control probabilities reached 91 and 87%, resp ectively without any difference between the treatment groups:: After s alvage laryngectomy, the 5- and 10-year loco-regional control probabil ities reached 97% without any difference between the treatment groups. For the whole population, overall survival reached 78 and 62.4% at 5 and 10 years, respectively. The actuarial incidence of second primary reached 19% at 10 years. Regarding the quality of voice, overall there was a trend towards a worse satisfaction index, more hoarseness and m ore breathiness after PL than after L or RT. Conclusions: Our data sug gested that assuming proper selection of patients, RT and L yielded si milar outcomes and functional results. Local recurrence can be adequat ely salvaged by surgery. On the Other hand, PL appeared to yield simil ar loco-regional control probability but with a worse quality of voice . (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.