Outcomes of Surgical Bed Versus Tumor Margins in Trans-Oral Resection of Early Glottic Cancer

TL;DR

This study compares surgical bed and tumor margin status in early glottic cancer surgery to determine their impact on patient outcomes.

Contribution

The study evaluates whether tumor margin involvement affects outcomes when surgical bed margins are disease-free in early glottic cancer surgery.

Findings

Recurrence occurred only in patients with disease-free surgical bed and tumor margins.

Disease-free survival was 100% in patients with disease-free surgical bed but involved tumor margins.

No statistically significant differences in outcomes were found between the groups.

Abstract

To assess which margin status, surgical bed margin (SBM) or tumor margin (TM) correlates best with outcome following transoral laser microsurgery (TLM) for early (Tis-T2N0M0) glottic cancer. A retrospective cohort study including patients with early (T1-2) glottic cancer. Data on TM status, SBM status, recurrence rate, and disease-free survival (DFS) were retrieved from the medical records of all patients who underwent vocal fold (VF) cordectomy due to Tis-T2N0M0 glottic squamous cell carcinoma from January 2013 to February 2021. Only patients with available data on both SBM and TM status were included in the study. Forty patients, 34 (85%) with disease-free SBM and TM, and 6 (15%) with disease-free SBM but involved TM, were included. Four (10%) patients developed recurrence, all in the group of both disease-free SBM and TM. The recurrence, 2-year disease free survival and survival at the end of follow-up (median 37.5 months) rates were 11%, 94.1% and 97.1% and 0%, 100% and 100%, in the groups of disease-free SBM and TM and disease-free SBM but involved TM, respectively. There were no statistically significant group differences. TM involvement, in the presence of disease-free SBM, did not compromise outcome.