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Background: There are limited data on the role of laser-assisted surgery for early glottic cancer in elderly patients., Methods: This retrospective study was conducted on a series of 130 consecutive cases of early glottic carcinoma occurring in elderly patients (>65 years old) treated with CO(2) laser surgery., Results: The overall and disease-specific survival rates were 87.7% and 99.2%, respectively. The rates of local disease control after primary laser surgery, ultimate local control with laser alone, and laryngeal preservation were 84.6%, 93.8%, and 96.9%, respectively. A shorter disease-free survival (DFS) was associated with the involvement of 1 or more specific laryngeal regions (arytenoids, ventricle, anterior commissure, vocal muscle, subglottis) (p = .01) and the status of the surgical margins (p = .002); on multivariate analysis, only the latter remained prognostically significant vis-à-vis the DFS (p = .002)., Conclusions: Even in elderly patients with early glottic carcinoma, endoscopic laser surgery is an effective treatment., (Copyright © 2012 Wiley Periodicals, Inc.)

Despite advances in laryngeal squamous cell carcinoma (LSCC) treatment, patient survival has not improved in the last two decades. Novel, more effective strategies should be based on receptor-mediated LSCC-targeted therapy. The epidermal growth factor receptor (EGFR) is the most widely studied molecular target. MASPIN multifaceted anti-tumor effects have been rarely evaluated in LSCC. The aims of this study were to investigate EGFR and MASPIN expression and the role of sub-cellular MASPIN localization in LSSC. MASPIN and EGFR expression and the sub-cellular localization of MASPIN were assessed using a computerized image analysis system in 108 consecutive cases of operable LSCC. The rates of occurrence of lymph node metastases and recurrent disease were lower in patients with a nuclear pattern of MASPIN expression (p = 0.004, p = 0.0028). As expected, the loco-regional recurrence rate was lower in N0 patients (p = 0.009), but the disease recurrence rate was even lower in N0 patients with a nuclear localization of MASPIN (p = 0.020). Disease-free survival was longer in cases of LSCC with a nuclear MASPIN pattern (p = 0.003). The intensity of EGFR reactivity and the EGFR area fraction were unrelated to the clinico-pathological and prognostic parameters in LSCC. A nuclear MASPIN pattern is a promising prognostic indicator in LSCC, but further evidence is needed before elective neck dissection can be considered for cN0 LSCCs with a non-nuclear MASPIN pattern. Although a better understanding of the mechanisms behind sub-cellular MASPIN localization is mandatory, re-activating nuclear MASPIN in association with specific chemotherapeutic agents may be an important goal in the treatment of LSCC.

Subsequent to previous experience in the surgical treatment of vocal cord atrophy using various materials (Teflon, Hydron Gel, Gax Collagene) the authors treated severe glottic insufficiency using the Isshiki Type I Thyroplasty modified in terms of shape and thickness of the silicone prosthetic implant. This procedure provides several important advantages: it does not modify the mass, volume and stiffness of the operated vocal cord; it can be reversed or modified; it permits intraoperative control of the results. The first three cases operated with this technique are analyzed and videostroboscopic and electroacoustic evaluation are presented.