Source: www.ajho.com
Author: staff

A retrospective chart review undertaken at a Rush University Medical Center in Chicago, Illinois, indicates that transoral laser surgery to treat cancer of the tongue is as effective as open surgery. The less invasive procedure may also improve patients’ quality of life. The study reviewed data from 71 patients who underwent transoral laser microsurgery for squamous cell carcinoma of the base of the tongue. At 24 months, overall survival was 90% and disease-specific survival was 94%. Of the 46 patients for whom quality-of-life information was obtained, the majority reported mild or no pain, minimally impaired to normal swallowing, and normal speech.

Surgical approaches through the neck once provided the only safe access to the base of the tongue, although the voice box, trachea, esophagus, lymph nodes, muscles, and large nerves make surgical resection in this area difficult. Significant complications often included impairment of speech and of swallowing. Transoral laser microsurgery, using an endoscope with a lighted camera, a microscopic lens, and a CO-2 laser, enables surgeons to treat cancers that were not treatable previously.

Dr Guy Petruzzelli, study author and chief of the Section of Head, Neck and Skull Base Surgery at Rush University Medical Center, noted, “Due to the precision of this surgery, most patients require less adjuvant chemotherapy, and in some cases patients will not need chemotherapy. And the functional outcomes are superior. Patients are able to speak and swallow much sooner and better than with an open technique.”

Of patients responding, 91% reported mild or no pain, and 97% had minimal impairment or normal swallowing function. Use of a gastrostomy tube averaged slightly more than 3 months overall. None of the patients interviewed were using a gastrostomy tube after 18 months. In addition, 69.6% of patients reported normal speech.

Source:
American Journal of Hematology/Oncology, August 2009