Oncological outcomes of transoral surgery with a laryngeal monopolar cautery and CO2 laser in stage 1 glottic cancer

Objective: Reliable alternative methods in performing transoral surgery for early-stage glottic cancer are of clinical importance for easy accessibility and widespread use. The purpose of this study is to compare the oncological outcomes of transoral excision with a laryngeal monopolar cautery with those using the rigid CO2 laser and to show the effectiveness of both methods with evidence. Methods: Patients who were diagnosed with early-stage T1 glottic laryngeal cancer between January 2000 and October 2014 and those who underwent a transoral excision with either a CO2 laser or laryngeal monopolar cautery were included. Five-year overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), larynx preservation (LP) rate, duration of the operation, and length of hospital stay were calculated for the group comparison. Subgroups, which are composed of patients with T1a, T1b, and anterior commissure involvement, were also compared. In addition, the 10-year survival rates of the patients in the cautery group were examined. Results: In total, 56 patients (25 who underwent surgery with a cautery and 31 with a CO2 laser) were included in the study. The five-year OS rates of the cautery and CO2 laser groups were 92.0% and 96.8%, and the LP rates were 95.8% and 96.6%, respectively. The 5-year DSS rates were 100.0% for both groups. No statistical difference was observed between the groups and subgroups. The 10-year OS and DSS rates for the cautery group were 80.0% and 96.0%, respectively. Conclusion: Similar oncological outcomes were obtained in both methods. The results of this study indicate that the use of a laryngeal monopolar cautery is a reliable alternative method in cases where laser is not available.