Investigation of factors increasing the recurrence risk in laryngeal cancer after laser surgery

Aim: Larynx cancer is one of the most common cancer in the upper respiratory and gastrointestinal system. The treatment of larynx cancer is changed in last 3 or 4 decades by the improvements in conservative surgery, chemotherapy and radiotherapy. This study aimed to determine negative prognostic factors in larynx cancer after laser surgery.Materials and Methods: In this study we retrospectively analyzed 40 larynx cancer patients who were surgically treated with transoral microendoscopic laser surgery in Cukurova University Faculty of Medicine Otolaryngology Department. Patients were dived in to two groups in the name of recurrent and non-recurrent group. Patients in these groups are compared according to tumor extension to the subregions of the larynx (anterior commisure, ventricle floor and subglottic regions) and immunohistochemical expression of p53, Ki-67 and c-erbB-2 proteins.Results: The local recurrence times for recurrent group were in between 1 month and 5 years and mean recurrence time was 12.95 month. Anterior involvement was observed in 11 patients of recurrent group and in 6 patients of non-recurrent group. Ventricle floor involvement was observed in 12 patients of recurrent group and in 5 patients of non-recurrent group. Subglottic extension was observed in 2 patients of recurrent group and in 3 patients of non-recurrent group. There were 2 patients with no involvement of these 3 subregion in recurrent group and 12 patients in non-recurrent group. After statistical evaluation ventricle floor involvement is found more common in recurrent group with statistically significant(p=0.025). After the immunohistochemical evaluation, p53, Ki-67 and c-erbB-2 positivity was found 9/20(%45), 16/20(%80) and 3/20(%15) in recurrent group respectively. In non-recurrent group positivity of p53, Ki-67 and c-erbB-2 was found 14/20(%70), 17/20(%85), 8/20(%40) respectively. After the statistical evaluation p values for these 3 parameters calculated as 0.11, 0.677, 0.077, and as a result of this evaluation we could not find any significant difference in between these two groups.Conclusion: Finally we found that good exposition of lesion and quality of excision related with local recurrence in laser surgery. We could not find any prognostic importance of over-expression of p53, Ki-67 and c-erbB-2 in larynx cancer treated with laser surgery.