# Transoral Laser Microsurgery Outcomes in Early-Stage Glottic Laryngeal Cancer at a Tertiary Center

## TL;DR

This study shows that transoral laser surgery is effective for early-stage throat cancer with low complications, but recurrence is higher in certain cases.

## Contribution

The study provides new clinical data on transoral diode laser microsurgery outcomes for early-stage glottic laryngeal cancer at a specific tertiary center.

## Key findings

- Transoral diode laser microsurgery had a low complication rate (8%) and no need for tracheotomy.
- Local recurrence occurred in 9.6% of patients, with higher recurrence in those with anterior commissure involvement.
- The mean follow-up period was 25.3 months with acceptable survival outcomes.

## Abstract

Introduction and aim: Curative treatment options for early-stage glottic laryngeal cancer include primary radiation therapy, open surgical techniques, and transoral laser microsurgery. In the last decade, transoral laser microsurgery has become a standard approach in many institutions due to its minimally invasive nature. This study aimed to evaluate the oncologic outcomes, complication rates, and therapeutic efficacy of transoral diode laser microsurgery in patients with early-stage (Tis, T1, T2) glottic laryngeal cancer.

Materials and methods: The retrospective data of 52 patients treated with transoral diode laser microsurgery at the ENT Clinic of Zonguldak Bülent Ecevit University between January 2021 and December 2024 were analyzed. Patients' demographic characteristics, tumor stages, surgical margin status, postoperative complications, recurrence rates, and survival outcomes were evaluated.

Results: Of the 52 patients in the study, 25 were in Tis, 20 in T1, and seven in T2 stage. The mean age of the patients was 65.5 years; 94.2% were male, and 5.8% were female. The mean follow-up period was 25.3 months. The postoperative complication rate was 8%, and the most common complications were vocal cord edema and granuloma formation. The local recurrence rate was 9.6%. The recurrence rate was higher in patients with anterior commissure involvement. No patient required a tracheotomy.

Conclusion: Transoral diode laser microsurgery is an effective treatment modality for early-stage glottic laryngeal cancers with a low complication rate and short hospitalization period. The risk of recurrence is higher, especially in patients with anterior commissure involvement, and this patient group should be followed more closely.