Comparison of laser microsurgery and open partial laryngectomy for T1-2 laryngeal cancer treatment

BACKGROUND: This study aims to investigate the clinical efficacy of transoral laser microsurgery and open partial laryngectomy (OPL) in treating T1-2 laryngeal cancer. METHODS: A retrospective analysis was conducted of 182 patients with T1-2 cancer with anterior vocal commissure (AVC) involvement. The local control (LC), disease-free survival (DFS) and overall survival (OS) rates at 5-year follow-up and the influencing factors were analyzed. RESULTS: No significant difference was observed in the LC or DFS rates between the two groups at 3- and 5-year follow-up. No significant difference was found between the two groups with T1-stage disease. The 5-year LC rates were significantly different from patients with grade 3 or 4 tumors on indirect laryngoscopy and patients with class III or IV tumors on the modified Mallampati test (MMT) (log-rank test: χ(2)=8.037, P=0.005). The 3-year LC rate of OPL in the depth of pathological infiltration (3–5 mm) group was found to be significantly higher than that of TLM. Significant differences in pathological infiltration depth (3–5 mm) existed between the two groups (log-rank test: χ(2)=5.786, P=0.016). CONCLUSIONS: T1 lesions are generally limited and superficial, and laser surgery can be well-controlled. For patients with difficult airway exposure, surgeons should have extensive surgical experience and skills. It is recommended that a variety of equipment should be ready so that surgeons can convert to open surgery at any time. For patients with a deep infiltration depth, surgeons should examine laryngoscopy imaging results before surgery.