Long-term oncologic outcomes of carbon dioxide laser cordectomy for early glottic cancer: a retrospective cohort study

Background: Transoral carbon dioxide (CO 2 ) laser cordectomy is widely used to preserve the larynx in patients with early glottic cancer.However, long-term tumor control and treatment of local recurrence remain important when assessing outcomes.We examined oncologic outcomes after primary CO 2 laser cordectomy and described the treatments used after local recurrence.Methods: We reviewed the records of 128 consecutive patients treated between 2010 and 2024 for Tis-T2N0 glottic squamous cell carcinoma.All underwent primary transoral CO 2 laser cordectomy.Time-to-event outcomes were estimated using the Kaplan-Meier method.Treatments after local recurrence were described without comparative analysis.Results: Median follow-up was 62 months (interquartile range, 38-91 months).Local recurrence occurred in 18 patients (14.1%).Estimated 5-year local control, disease-specific survival, and overall survival were 84.7%, 97.7%, and 91.8%, respectively.At the last recorded follow-up, 124 patients (96.9%) retained the larynx.Repeat laser microsurgery was the first salvage procedure in 14 of the 18 patients with local recurrence.Conclusion: After primary CO 2 laser cordectomy, the estimated 5-year local control was 84.7%, and 96.9% of patients retained the larynx at last follow-up.Repeat laser microsurgery was commonly used as the first salvage procedure for selected local recurrences.