Quality of life and voice in patients after laser cordectomy for Tis and T1 glottic carcinomas.

Abstract

Laser cordectomy is gaining popularity for treatment of early glottic carcinoma, but little is known about vocal and quality of life (QOL) outcomes as a function of extent of resection. We prospectively examined QOL and vocal function of patients with carcinoma in situ (Tis) or T1 glottic carcinomas after laser cordectomy. Patients (n = 75) were grouped into those who underwent unilateral subepithelial or subligamental resection (group A, n = 45); those who underwent unilateral transmuscular or total cordectomy (group B, n = 17); and those who underwent extended or bilateral cordectomy including the anterior commissure (group C, n = 19). The European Organization for Research and Treatment of Cancer head and neck cancer specific module (QLQ-H&N35), voice handicap index (VHI), and objective vocal function were examined before and 1 year after cordectomy and compared among the groups. No major complications were encountered, but local recurrence occurred in 10 patients, with group C showing the highest rate (6/19, 31.6%). Patient-reported speech and social contact scores of QOL questionnaire and VHI scores after surgery were higher in groups B and C than in group A (p < .05). The scores and perceptual and acoustic data were generally improved in all groups after surgery, but were statistically significant only in group A (p < .03). Our data suggest that early glottic cancers with a limited extent and infiltration depth have improved outcomes, both oncologically and functionally, compared to those lesions requiring extensive laser resection.