1194-1195 / 2351
Margin status
Anterior/posterior
commissure
Extralaryngeal extension
Functional outcomes in T2-T3
and QoL
Subglottic involvement
HOT TOPICS
TRANSORAL CO2 LASER MICROSURGERY
AC involvement in the cranio-caudal plane (T2-3)
Arytenoid fixation
Massive infiltration of PES
and PGS
Thyroid cartilage/thyrohyoid
membrane infiltration
Peretti et al, Curr Opin Otorhinolaryngol Head Neck Surg (2016)
C
URRENT
O
PINION
Reasonable limits for transoral laser microsurgery
in laryngeal cancer
Giorgio Peretti
a
, Cesare Piazza
b
, Francesco Mora
a
, Sabrina Garofolo
a
, and
Luca Guastini
a
Purpose of review
Transoral laser microsurgery (TLM) is widely acknowledged to offer several advantages in the treatment of
early and selected intermediate-advanced laryngeal cancers. Nevertheless, a number of issues are still
under debate. The purpose of this review is to discuss the reasonable limits for TLM i laryngeal cancer to
highlight its most appropriate and reproducible indications, putting this therapeutic tool in the right
perspective within a comprehensive frame of alternative treatment strategies such as open partial
laryngectomies and nonsurgical organ preservation protocols.
Recent findings
Inadequate laryngeal exposure, anterior commissure involvement in the cranio-caudal plane (T2), invasion
of the posterior paraglottic space with arytenoid fixation, massive infiltration of the preepiglottic space, and
even minor thyroid cartilage erosion (T3) represent the most controversial applications of TLM in
management of glottic and supraglottic cancer.
Summary
Published oncological results appear to be satisfactory when TLM is applied to T1-T2 and accurately
selected T3 glottic and supraglottic cancers with favourable exposure. Caution should be used for more
EDITORIAL
mercoledì 29 giugno 16