A new study says that transoral laser surgery for tongue cancer may be equally effective as a more invasive open surgery. Laser microsurgery is also believed to be instrumental in improving the patient’s quality of life. This revelation was made by the investigators from the Rush University Medical Center.
It seems that traditional treatments of cancer at the base of the tongue included complex open surgical approaches through the neck. However, such procedures tended to often get complicated because of the fragile neck structures like the trachea, voice box, esophagus, muscles and large nerves, etc. Such surgical resections could get complex because of certain complications like speech and swallowing impairment.
The advancements made in transoral laser microsurgery are believed to have made the treatment of such kind of cancers more approachable. Such a surgery is evidently performed through the opening of the mouth, with the help of an endoscope with a lighted camera and microscopic lens to view the region. In this procedure, surgeons use a CO-2 laser and micro-staging to remove the cancer in small pieces, so as to avoid its disruption in the surrounding tissues. This in turn lowers complications and the chances of getting infections.
Study author, Dr. Guy Petruzzelli, 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, says, “Due to the precision of this surgery, most patients require less adjuvant chemotherapy and in some cases patients will not need chemotherapy. And the functional outcomes are superior. Patients are able to speak and swallow much sooner and better than with an open technique.”
For the purpose of the study, the charts of around 71 patients were reviewed who had undergone transoral laser microsurgery for squamous cell carcinoma of base of the tongue. It was observed that, after 2 years there was 90% overall survival, while the disease specific survival was noted to be about 94%. More so, it was also observed that some patients experienced little or no pain, normal speech, and minimally impaired to normal swallowing.
“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,” explains Petruzzelli.
More so, it was even noted that none of the interviewed patients seemed to be using gastrostomy tube 1.5 years following the surgery; with an overall gastrostomy use of a little more than 3 months. In fact it was also stated that almost 70% of the patients allegedly reported of having “normal” speech.
This study has been published in the journal Otolaryngology – Head and Neck Surgery.