Oncological Impact of Surgical Margin Status After Transoral Laser Microsurgery for Early Glottic Cancer.

Abstract

Transoral laser microsurgery is a well-established treatment for early glottic cancer. However, managing patients with close/positive margins remains debated. This study analyzes the relationship between resection margins and oncologic outcomes. Patients with early glottic cancer who underwent transoral laser microsurgery were included. We compared clinical characteristics, recurrence-free survival, laryngeal preservation, and disease-specific survival between negative and close/positive margin groups. Among 107 patients, 49 (45.8%) had close/positive margins. The recurrence-free survival rate was significantly lower in the close/positive margin group. Anterior commissure involvement was a significant risk factor for recurrence. The median recurrence time for the close/positive margin group was 18.5 months, similar to the negative margin group. Laryngeal preservation and disease-specific survival were similar between groups with > 95%. Patients with close/positive margins in early glottic cancer showed similar disease-specific survival and laryngeal preservation rates as negative margins; despite lower recurrence-free survival, suggesting a follow-up approach is sufficient.