{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:35:24Z","timestamp":1787924124395,"version":"build-2784847793"},"reference-count":14,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T00:00:00Z","timestamp":1626998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012424","name":"School of Medicine, University of California, San Diego","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012424","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Transoral laser microsurgery (TLM) is commonly utilized for early glottic cancer and offers favorable oncologic and functional outcomes. However, the survival implications of salvage therapy for recurrent or persistent disease have not been definitively characterized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective, national database cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were extracted from Veterans Health Affairs (VHA) Informatics and Computing Infrastructure (VINCI) concerning the TLM\u2010based management of T1\u2013T2 glottic squamous cell carcinoma patients between 2000 and 2017. Patients were characterized as either requiring TLM\u2010only, or in cases of persistent or recurrent local disease, TLM plus change in treatment modality (radiotherapy, chemoradiotherapy, or open surgery). Predictors of overall survival (OS), cancer\u2010specific survival (CSS), and salvage\u2010free survival were evaluated via Cox and Fine\u2010Gray models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 553 patients (70.9% T1a, 13.4% T1b, 15.7% T2) were included, with a median follow\u2010up time of 74.5\u2009months. The need for non\u2010TLM salvage increased along with more advanced disease (11.7% T1a, 29.7% T1b, 32.2% T2). Compared to patients with T1a disease, those with T1b and T2 tumors initially treated with TLM had a significantly higher probability of receiving non\u2010TLM salvage (T1b: HR 2.70, 95% CI: 1.61\u20134.54; T2: HR 3.02, 95% CI: 1.88\u20134.84). In a multivariable model, receipt of non\u2010TLM salvage was not a significant predictor of either OS (HR\u00a0=\u00a00.91, 95% CI: 0.62\u20131.33, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.624) or CSS (HR 1.21 95% CI 0.51\u20132.86, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.667).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The majority of patients with early glottic cancer that are managed with TLM do not require additional salvage therapy. When non\u2010TLM salvage was required, there was no decrement in OS or CSS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:2766\u20132772, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29740","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T10:10:59Z","timestamp":1627035059000},"page":"2766-2772","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Salvage Following Transoral Laser Microsurgery for Early Glottic Cancer in National Veteran Database"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9242-844X","authenticated-orcid":false,"given":"Rohith S.","family":"Voora","sequence":"first","affiliation":[{"name":"University of California, San Diego School of Medicine  La Jolla California U.S.A."},{"name":"Division of Otolaryngology\u2010Head and Neck Surgery, Department of Surgery University of California\u2010San Diego  San Diego California U.S.A."},{"name":"Veterans Affairs San Diego Healthcare System  San Diego California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1149-9532","authenticated-orcid":false,"given":"Bharat","family":"Panuganti","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2010Head and Neck Surgery, Department of Surgery University of California\u2010San Diego  San Diego California U.S.A."},{"name":"Moores Cancer Center  La Jolla California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Flagg","sequence":"additional","affiliation":[{"name":"University of California, San Diego School of Medicine  La Jolla California U.S.A."},{"name":"Division of Otolaryngology\u2010Head and Neck Surgery, Department of Surgery University of California\u2010San Diego  San Diego California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Kumar","sequence":"additional","affiliation":[{"name":"Veterans Affairs San Diego Healthcare System  San Diego California U.S.A."},{"name":"Department of Radiation Medicine and Applied Sciences University of California San Diego School of Medicine  La Jolla California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander S.","family":"Qian","sequence":"additional","affiliation":[{"name":"University of California, San Diego School of Medicine  La Jolla California U.S.A."},{"name":"Department of Radiation Medicine and Applied Sciences University of California San Diego School of Medicine  La Jolla California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil V.","family":"Kotha","sequence":"additional","affiliation":[{"name":"University of California, San Diego School of Medicine  La Jolla California U.S.A."},{"name":"Veterans Affairs San Diego Healthcare System  San Diego California U.S.A."},{"name":"Department of Radiation Medicine and Applied Sciences University of California San Diego School of Medicine  La Jolla California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmund M.","family":"Qiao","sequence":"additional","affiliation":[{"name":"University of California, San Diego School of Medicine  La Jolla California U.S.A."},{"name":"Veterans Affairs San Diego Healthcare System  San Diego California U.S.A."},{"name":"Department of Radiation Medicine and Applied Sciences University of California San Diego School of Medicine  La Jolla California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Weissbrod","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2010Head and Neck Surgery, Department of Surgery University of California\u2010San Diego  San Diego California U.S.A."},{"name":"Moores Cancer Center  La Jolla California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent","family":"Rose","sequence":"additional","affiliation":[{"name":"Veterans Affairs San Diego Healthcare System  San Diego California U.S.A."},{"name":"Moores Cancer Center  La Jolla California U.S.A."},{"name":"Department of Radiation Medicine and Applied Sciences University of California San Diego School of Medicine  La Jolla California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7885-4327","authenticated-orcid":false,"given":"Ryan K.","family":"Orosco","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2010Head and Neck Surgery, Department of Surgery University of California\u2010San Diego  San Diego California U.S.A."},{"name":"Veterans Affairs San Diego Healthcare System  San Diego California U.S.A."},{"name":"Moores Cancer Center  La Jolla California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-019-0367-2"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12790"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcma.2017.04.002"},{"key":"e_1_2_7_5_1","unstructured":"US Department of Veterans Affairs.Corporate data warehouse. 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