{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T13:19:30Z","timestamp":1779196770961,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T00:00:00Z","timestamp":1625616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives\/Hypothesis<\/jats:title>\n                    <jats:p>\n                      Laryngeal squamous cell carcinoma (LSCC) has a non\u2010negligible incidence in elderly patients. However, there is still no clear indication on the ideal treatment for early\u2010intermediate glottic LSCC in this specific age group. Both surgical and nonsurgical approaches may be burdened by complications and sequelae that negatively impact patient's health. In this setting, carbon dioxide transoral laser microsurgery (CO\n                      <jats:sub>2<\/jats:sub>\n                      TOLMS) is a promising minimally invasive treatment option.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective case series in a single tertiary academic institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients who underwent CO\n                      <jats:sub>2<\/jats:sub>\n                      TOLMS for Tis\u2010T3 glottic LSCC from 1997 to 2017 were reviewed. Demographic, clinical, and tumor characteristics, as well as postoperative complications were recorded. Overall (OS), disease\u2010specific (DSS), recurrence\u2010free (RFS), laryngo\u2010esophageal dysfunction free survivals (LEDFS), and organ preservation (OP) were calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 134 patients (mean age, 80\u2009\u00b1\u20094\u2009years; median, 79; range, 75\u201393) were included in the study. Seven lesions were classified as pTis, 65 as pT1a, 22 as pT1b, 35 as pT2, and 5 as pT3. No treatment\u2010related death was observed. Twenty\u2010eight (20.9%) patients reported 10 surgical and 19 medical complications. Five\u2010year OS, DSS, RFS, LEDFS, and OP were 68.9%, 95.4%, 79.5%, 66%, and 92.5%, respectively. Age and comorbidities were associated with OS and LEDFS. Advanced T categories were negatively correlated with OS, DSS, RFS, LEDFS, and OP. Age and comorbidities were not significant risk factors for complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      CO\n                      <jats:sub>2<\/jats:sub>\n                      TOLMS can be considered a valuable therapeutic approach for selected Tis\u2010T3 glottic LSCC even in the elderly given its favorable oncologic outcomes and minimal aggressiveness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      4\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 132:135\u2013141, 2022\n                    <\/jats:p>\n                  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Health University of Brescia  Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1008-7333","authenticated-orcid":false,"given":"Alberto","family":"Deganello","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2010Head and Neck Surgery ASST Spedali Civili  Brescia Italy"},{"name":"Department of Surgical and Radiological Sciences and Public Health University of Brescia  Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Peretti","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2010Head and Neck Surgery IRCCS Ospedale Policlinico San Martino  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2391-9357","authenticated-orcid":false,"given":"Cesare","family":"Piazza","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2010Head and Neck Surgery ASST 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