CO2 laser surgery produces better outcomes for tongue cancer patients, study reports

JULY 21, 2009--Results of a new study, published in Otolaryngology--Head and Neck Surgery, show that noninvasive laser surgery is just as effective as invasive open surgery for cancer at the base of the tongue--and may improve post-surgery quality of life. Through-the mouth laser microsurgery is now viable for otherwise inoperable cancer: An endoscope with a lighted camera and microscopic lens enables viewing, and a CO2 laser and micro-staging enable precision tumor removal.

JULY 21, 2009--Results of a new study show that noninvasive laser surgery is just as effective as more invasive open surgery for treatment of tongue cancerdeep within the mouth--and may improve post-surgery quality of life. The study, by Rush University Medical Center, is published in the journal Otolaryngology--Head and Neck Surgery.

Historically, the base of the tongue could be safely accessed only through complicated open surgical approaches through the neck--and often such procedures resulted in significant complications including speech and swallowing impairment. Advances in transoral (through-the-mouth) laser microsurgery enable treatment using an endoscope with a lighted camera and microscopic lens to view the area. Using a CO2 laserand micro-staging, surgeons carefully remove the tumor in small pieces minimizing disruption to nearby tissues, thereby reducing complications and the likelihood of infections. With magnification of normal and abnormal tissue the surgery is very precise which contributes to very good cancer outcomes.

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

The study involved a retrospective chart review of 71 patients who underwent transoral laser microsurgery for squamous cell carcinoma of the base of the tongue. At 24 months, overall survival was 90 percent and disease specific survival was 94 percent. Quality-of-life data, obtained for 46 patients, revealed the majority had mild or no pain, minimally impaired or normal ability to swallow, and normal speech.

In the study, 91 percent of patients responding experienced "mild" or "no pain." Also, 97 percent had "minimal impairment" or "normal" swallowing function. In fact, no patients interviewed were using a gastrostomy tube after 18 months, with average gastrostomy use of just over three months overall. Finally, 69.6 percent of patients reported "normal" speech.

"Transoral laser surgery is an acceptable and in many cases preferred option for managing appropriately sized tumors of the back of the tongue. Its overall safety and functional outcomes are in many cases superior to traditional open surgeries and potentially high dose chemotherapy and radiation," said Petruzzelli.

For more information see the paper, "rush"+AND+"university"&search_reqcount=20&search_reqfirst=1&search_sort=relevance&search_source=Otolaryngology+-+Head+and+Neck+Surgery&search_startpage=&search_text1=rush+university&search_text2=&search_text3=&search_text4=&search_volume=&search_within1=&search_within2=&search_within3=&search_wordsexactly=yes&search_yearend=&search_yearstart=&searchDisciplineField=all&select1=relevance&select1=relevance&select2=no&select2=no&select3=20&select3=20&terms1=rush+university&terms2=&terms3=" target="_blank">Functional and oncologic results following transoral laser microsurgical excision of base of tongue carcinoma, in Otolaryngology--Head and Neck Surgery, the official scientific journal of the American Academy of Otolaryngology--Head and Neck Surgery Foundation (AAO-HNSF) and the American Academy of Otolaryngic Allergy (AAOA).

Posted by Barbara G. Goode,, for BioOptics World.

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