Quality of Life After Laser Cordectomy in Early Glottic Cancer

Laryngeal cancer is common in the Taiwanese populations. Before early 80's, open laryngectomy was the suggested treatment modality for laryngeal cancer. Patients of laryngectomy lost speech and should communicate by using prosthesis. So after 90's, medical organ preservation by chemoradiation therapy took the place of operation. Unfortunately, from the recent review, five-year survival rate was decreasing and is even lower than that reported 10 years ago. In 1983-1985 it was 68.1% but decreased to 64.7% in 1992-1999. It is the only cancer type of decreasing survival in 24 index cancers. Laser resection of laryngeal tumor was first reported by Jako and Strong and widely used in the Europe. Dr Steiner and his colleagues developed a non-en block resection technique made microscopic resection more easily and would not be limited by tumor location or size so much. The investigators used transoral microscopic laser (TLM) in early glottic cancer and reported five-year overall survival as 97%. TLM five-year disease control rate was reported as 85%. There are some reports about TLM in advanced stage laryngeal cancer and overall 5-year survival rate can be achieved as high as 55%. Present project is planning to develop a comprehensive organ preservation protocol based on microinvasive TLM as primary treatment modality for early glottic cancer without neck or distant metastasis. The objects of the project are as followed. 1. Long term outcomes by performing the treatment protocol. The outcome measurements include local control rate, overall and disease specific survival, larynx preservation rate. 2. The difference between surgical samples and pretreatment imaging examination. 3. The role of adjuvant therapy. 4. Management and follow-up in neck metastasis. 5. Searching for risk factors and predictor factors. 6. Adequate salvage treatments in local or regional recurrence. 7. Realizing failure patterns and appropriate follow-up protocol according to it.