Functional and Oncologic Outcomes of Octogenarians Undergoing Transoral Laser Microsurgery for Laryngeal Cancer

• Published in: OTO open : the official open access journal of the American Academy of Otolaryngology--Head and Neck Surgery Foundation 2021-07, Vol.5 (3), p.2473974X211046957-n/a
• Main Authors: Lee, Changseok, Forner, David, Noel, Christopher W., Taylor, Victoria, MacKay, Colin, Rigby, Matthew H., Corsten, Martin, Trites, Jonathan R., Taylor, S. Mark
• Format: Article
• Language: English
• Subjects: Cancer; Clinical outcomes; complications; frailty; geriatrics; glottic cancer; Head & neck cancer; head and neck neoplasms; Laryngeal cancer; larynx cancer; Length of stay; Microsurgery; Oldest old people; Original Research; Throat cancer; Throat surgery; transoral laser microsurgery; voice function
• ISSN: 2473-974X; 2473-974X
• DOI: 10.1177/2473974X211046957

Objective To evaluate the oncologic and functional outcomes of transoral laser microsurgery (TLM) for glottic cancers in patients ≥80 years. Study Design Prospectively collected case series. Setting QEII Health Sciences Centre, Halifax, Canada. Methods This case series used a prospectively collected glottic cancer database to examine consecutive elderly patients (≥80 years old) undergoing TLM. Kaplan-Meier analysis was used to evaluate rates of disease-free, disease-specific, and overall survival as the primary end points of oncologic control. Secondary functional outcomes included voice function, length of hospital stay, and time to readmission. Results From 2005 to 2017, 17 octogenarian patients underwent TLM for glottic cancer. Median follow-up was 4.19 years (interquartile range, 0.71-6.95). Kaplan-Meier estimates of 5-year survival were 78.4% (disease free), 92.9% (disease specific), and 81.9% (overall). The median length of hospital stay was 1 day (range, 0-8). There was only 1 readmission within 30 days of surgery. No patients in this study developed significant surgical or postoperative complications requiring unplanned readmissions. Patient-perceived voice function improved to normal after treatment in 62.5% of patients. Conclusion The results of this study suggest that TLM is a safe and effective treatment modality for glottic cancer in patients aged ≥80 years, providing good oncologic control and satisfactory functional outcomes.