• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.19 no.1
• /
• pp.7-10
• /
• 2008

The early glottic cancers are traditionally treated by radiotherapy or endoscopic surgery. The excellent effectiveness of both treatment modalities for local control, larynx preservation, and disease specific death is similar. Therefore, functional voice outcome after treatment is one of the most important factors in the choice of treatment for early glottic cancer. To assess the functional outcomes and compare the voice quality in patients with early glottic cancer treated with curative intent with radiotherapy or laser cordectomy, we performed literature review. Most studies showed that the voice quality after radiation therapy is slightly better than that after laser cordectomy. Subanalysis according to types of laser cordectomy, however, indicates that voice quality depends on type of laser cordectomy. Especially, type I or type II laser cordectomy might be superior to other types of laser cordectomy and radiation therapy. We conclude that the laser cordectomy is a good surgical alternative for properly selected early glottic cancer including professional voice users.

• Korean Journal of Head & Neck Oncology
• /
• v.29 no.2
• /
• pp.58-61
• /
• 2013

Early glottic cancer can be effectively treated with surgery or radiotherapy showing the comparable treatment results. Since radiation therapy may be better in terms of voice preservation, it tends to be preferred in early glottic cancer. Most common recurrence site is glottis after radiation therapy and complete remission of glottic primary site followed by local recurrence limited to neck is very rare. The authors are reporting a patient with regional recurrence of central neck lymph nodes after radiation therapy for T1a glottic cancer.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.13 no.2
• /
• pp.139-144
• /
• 2002

Background and objectives : The various voice-conserving treatments are used for Tla staged glottic cancer. Especially, Tla staged glottic cancer has been shown excellent treatment result after laser cordectomy or radiotherapy. To evaluate which treatment results better voice after treatment made it valuable to define the exact indication and recommending treatment modality on the Tla staged glottic cancer patients. Method : The medical records of 75 patients with glottic TlaN0 cancer diagnosed at Asan medical center, University of Ulsan college of medicine form May, 1989 to July,2001 were retrospectively reviewed on the point of voice quality and oncology including 5-year survival rate and local control rate. Results : Laser cordectomy and radiotherapy showed 100% and 94.0% 5-year survival rate, respectively. And laser cordectomy had 94.3% local control rate while radiotherapy got 87.6% local control rate. Voice analysis of pretreatment and posttreatment were used to compare each result. Fundamental frequency(F0), shimmer, jitter, noise to harmony ratio(NHR), maximum confortable phonation time(MPT) and vocal efficiency(VE) were used for parameters for voice analysis. Only in shimmer and MPT, we could find significant posttreatment difference between two therapies. In addition, we reviewed the total expenses for each therapy. Conclusion : On the basis of the oncologic result, both the laser cordectomy and radiotherapy had the similar results. Laser cordectomy showed the relatively acceptable voice as radiotherapy did. Laser cordectomy cost less than radiotherapy did. Laser cordectomy can be used for treatment about Tla staged glottic cancer.

• Korean Journal of Head & Neck Oncology
• /
• v.12 no.2
• /
• pp.201-205
• /
• 1996

Early detection of glottic cancer, facilitated by rigid telescopes or flexible fiberoptic laryngoscope in addition to sparse true vocal cord lymphatics, makes this a highly curable tumor in its early stage. Early glottic cancer has a high cure rate with only radiotherapy or conservative surgery. However complications such as mucositis with radiotherapy and voice complications with conservative surgery has raised recent interest in endolaryngeal laser cordectomy. Laser cordectomy can preserve phonatory function and avoid the complications such as mucositis of radiotherapy. To determine the effectiveness of laser cordectomy, the authors made a two year retrospective study of 23 early glottic cancer cases. Fourteen cases(60.9%) who underwent 1 to 3 endoscopic laser cordectomy with KTP-532 laser were cured with this procedure alone. Seven cases needed an additional radiotherapy and three cases needed therapy with salvage operation. We conclude that the endoscopic laser surgery is a good strategy for the properly selected glottic cancer.

• Korean Journal of Head & Neck Oncology
• /
• v.20 no.1
• /
• pp.19-23
• /
• 2004

Background and Objectives: Neck metastasis is one of the most important prognostic factor in head and neck squamous cell carcinoma. Recently, elective neck dissection has been widely accepted for accurate pathologic staging and elective treatment of neck. Occult metastasis rate of laryngeal cancer varies widely depending upon authors. To evaluate the rate and characteristics of occult metastasis and efficacy of the elective neck dissection in clinical N0 laryngeal cancer, we performed this study. Materials and Method: Seventy two patients (supraglottic cancer: 19 cases, glottic cancer: 53 cases) who underwent surgery for laryngeal cancer as an initial treatment from 1993 to 2002 were evaluated. All was underwent elective neck dissection at the time of surgery for the primary treatment. The record of patients and pathologic report were reviewed retrospectively. Results: Occult metastasis rate of supraglottic and glottic cancer were 42.1% (8/19) and 9.4% (5/53), respectively. According to T stage, the occult meastasis of supraglottic and glottic cancer was 20%, 0% in T1, 36.4%, 0% in T2, 100%, 40% in T2, 100%, 20% in T4, respectively. Occult metastasis was mostly confined within level II (69.2%), III (76.9%), IV (23.1%). Conclusion: Based on ours results, elective neck dissection might be needed in treating of clinically N0 all supraglottic cancer and advanced T3, T4 glottic cancer.

• Korean Journal of Bronchoesophagology
• /
• v.16 no.1
• /
• pp.20-26
• /
• 2010

Transoral $CO_2$ Laser Microsurgery of glottic Carcinoma is replacing external approaches. The qualify of life after surgery for laryngeal cancer may be as important as complete resection of the tumor for patient. Transoral $CO_2$ laser cordectomy for the management of early laryngeal cancer has advantages with regard to oncological results, preservation of laryngeal functions, morbidity and cost in comparison to those of open surgery or radiation therapy. Moreover, transoral laser surgery can be a useful choice as a salvage surgery in radiation therapy failed early glottic cancer. A classification of laryngeal endoscopic cordectomies which included eight different types was described by the European laryngological Society in 2000. We will also introduce type VI which was newly proposed recently.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.7 no.1
• /
• pp.32-38
• /
• 1996

The preservation of the voice-producing mechanism is an important feature in the management of laryngeal cancer by radiotherapy. But, radiation therapy has certain side effects such as mucositis, tissue edema, necrosis and fibrosis which could effect on normal voice production. Several subjective studies that used questionnaires and auditory perceptual judgements of voice have been interpreted to mean that radiation results in a normal or near-normal voice. Objective evidence of the status of vocal function after radiation treatment, however, is still lacking. We analyzed the changes that occur in voice parameters in a group of patients undergoing radiation therapy, in order to determine the effect of radiation on voice quality. In this study acoustic, aerodynamic measures of vocal function were used to determine the characteristics of voice production. We found that voice parameters in early glottic cancer changed meaningfully comparing to normal larynx with or without radiation and radiation therapy has an little effect on normal larynx.

• Radiation Oncology Journal
• /
• v.38 no.1
• /
• pp.11-17
• /
• 2020

Purpose: Definitive radiotherapy remains a primary treatment option for early stage glottic cancer. Intensity-modulated radiation therapy (IMRT) has emerged as the standard treatment technique for advanced head and neck cancers, whereas three-dimensional conformal radiotherapy (3D-CRT) has remained standard for early glottic cancers. We used the National Cancer Database (NCDB) to identify predictors of IMRT use and effect on outcome in these patients. Materials and Methods: We queried the NCDB from 2004-2015 for squamous cell carcinoma of the glottic larynx staged Tis-T2N0 treated with radiation alone. Logistic regression was used to identify predictors of IMRT. Cox regression was used to identify factors predictive of overall survival. Propensity matching was conducted to account for indication bias. Results: We identified 15,627 patients, of which 11% received IMRT. IMRT use rose from 2% in 2004 to 16% in 2015. Predictors of IMRT include: increased comorbidity, T2 stage, urban location, chemotherapy, treatment at an academic center, and later treatment year. Predictors of improved survival were female gender, higher income, lower stage, no chemotherapy, academic facility, and more remote year. There was no difference in survival between 3D-CRT and IMRT across all stages. Conclusions: The rate of IMRT use for early stage glottic laryngeal cancer has increased over time. There was no difference in outcome in patients receiving IMRT versus 3D-CRT across the cohort.

• Korean Journal of Head & Neck Oncology
• /
• v.10 no.2
• /
• pp.178-184
• /
• 1994

Laryngeal cancer is one of the most frequent cancers in the head and neck area. Clinical analysis was performed on 30 cases of treated $T_1$ glottic cancer patients. Early glottic cancer occured most frequently in male in their sixties and all were well or moderately well differentiated squamous cell carcinoma. Overall five year survival rate was 81.5% and there was no significant difference between stages or the differentiation of the diseases. Recurrence at the primary site, especially anterior commissure, was common, thus careful pre- and postoperative follow up evaluation is recommended.

• Korean Journal of Head & Neck Oncology
• /
• v.4 no.1
• /
• pp.29-34
• /
• 1988

Radiation therapy is generally considered to be the treatment of choice in $T_1$ glottic cancer, maninly because of preservation of voice function and its local control rate is comparable to that of surgery. Failures from radiation therapy can be ultimately salvaged by surgery. A retrospective analysis of the treatment of 25 patients with $T_1$ glottic cancer seen at the Yonsei Cancer Center from 1980 to 1984 is presented. Radiation dose to the target volume varied from 6400 to 7000 cGy in 6-7 weeks. The local control rate is 84%. Four patients had primary failure and three of these patients had salvage surgery. Of the 3 patients who had salvage surgery, 2 were cured and aonther one was died with progression of the disease. 5-year acturial and disease free survival rate are 91.1%,78.0% respectively.