Evaluation of early-stage laryngeal cancer in men: treatment outcomes and tolms radicality – a 6-year retrospective analysis

Abstract

Objectives. Laryngeal cancer is one of the most common oncological diseases in the head and neck region, particularly prevalent among male smokers and often diagnosed at early stages (T1 and T2). Transoral laser microsurgery (TOLMS) is a widely used minimally invasive technique for treating early-stage laryngeal cancer. This study evaluates the effectiveness of TOLMS, the achieved radicality, and the relationship between radicality and recurrence over six years in patients treated with this method. Materials and methods. A retrospective analysis from Kaunas Clinics included 88 male patients with early-stage laryngeal cancer who underwent surgery between January 1, 2019, and December 31, 2024. Statistical analysis using SPSS summarized demographic and clinical data with descriptive statistics, and compared tumor stage, surgical radicality, and recurrence rates using chisquare tests, with p<0.05 considered significant. Results. The study included 88 male patients, average age 68.6 years. Of these, 88.5% had risk factors like smoking, alcohol use, or toxic work exposure. The most common tumor type was infiltrative keratinizing moderately differentiated squamous cell carcinoma (95.4%), with four cases of sarcomatoid carcinoma (4.6%). R0 resection was achieved in 67 cases (76.1%), and histopathology showed no neoplastic changes in 63 cases (71.6%). Over six years, 10 recurrences occurred—7 within the first year and 3 between one and two years post-treatment. Recurrence was significantly associated with tumor stage (N) (Chi-square, p=0.02) and surgical radicality (Chi-square, p<0.001). Radicality was influenced by tumor stage (T) (Chi-square, p=0.032), with T1a being most frequent. Conclusions. TOLMS is an effective, safe treatment for early-stage laryngeal cancer, achieving high surgical radicality (R0 resection in 76.1%). Recurrence rates were influenced by tumor stage (N) and surgical radicality, with most recurrences occurring within the first year. These findings support TOLMS as a valuable treatment for early-stage laryngeal cancer.