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Wolfgang Steiner, MD; Oliver Fierek, MD; Petra Ambrosch, MD; Christian P. Hommerich, MD; Martina Kron, PhD

Arch Otolaryngol Head Neck Surg. 2003;129:36-43.

Objective  To determine the role of transoral laser microsurgery for base of tongue squamous cell carcinoma.

Design  Retrospective unicenter study of the oncologic and functional results of laser microsurgery of tongue base carcinoma performed between 1986 and 1997.

Settings  University hospital department.

Patients  We reviewed 48 previously untreated patients with base of tongue squamous cell carcinoma, who were treated with transoral laser microsurgery. Distribution of the T categories were T1, 2%; T2, 25%; T3, 15%; and T4, 58%; 94% belonged to the stages III and IVa. Selective neck dissection was performed in 43 patients; 23 patients underwent postoperative radiotherapy with or without simultaneous chemotherapy.

Main Outcome Measures  Local control rate, recurrence-free and overall survival rates, mean performance status scale scores for normalcy of diet and understandability of speech.

Results  The Kaplan-Meier 5-year local control rate was 85%. There was no local recurrence in T1 and T2 lesions, but there was a 20% local recurrence rate in T3 and T4 tumors. Kaplan-Meier 5-year recurrence-free and overall survival rates were 73% and 52%, respectively. Mean performance status scale scores were 92% for normalcy of diet and 88% for understandability of speech. Twenty-one patients survived at least 5 years after treatment. They have a preserved larynx and live without tracheostoma or gastrostomy tube.

Conclusions  Our concept of organ and function preserving laser microsurgery for selected patients with base of tongue cancer seems to be justified considering the achieved oncological and functional results. Final proof of the effectiveness of the new therapeutic concept presented herein requires well-designed prospective studies.

From the Department of Otorhinolaryngology–Head and Neck Surgery, University of Goettingen, Germany (Drs Steiner, Fierek, Ambrosch, and Hommerich); and the Department of Biometry and Medical Documentation, University of Ulm, Germany (Dr Kron).

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Arch Otolaryngol Head Neck Surg 2009;135:1225-1230.
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