Prognostic role of margin status in open and CO₂ laser cordectomy for T1a–T1b glottic cancer

Introduction: Cordectomy by laringofissure and transoral laser surgery has been proposed for the treatment of early glottic cancer. Objectives: The aim of this retrospective study was to evaluate the prognostic value of margin status in 162 consecutive cases of early glottic carcinoma (Tis–T1) treated with CO₂ laser endoscopic surgery (Group A) or laryngofissure cordectomy (Group B), and to compare the oncologic and functional results. Methods: Clinical prognostic factors, local recurrence rate according to margin status, overall survival and disease-free survival were analyzed. Results: Margin status is related to recurrence rate in both groups (p < 0.05) without significant differences between open and laser cordectomy (p > 0.05). The 5 years overall survival and disease-free survival were respectively 90.48% and 85.71% in Group A; 88.14% and 86.44% in Group B (p > 0.05). Lower tracheostomy rate, earlier recovery of swallowing function and shorter hospital stay were observed in Group A (p < 0.05). Conclusions: Margin status has a prognostic role in T1a–T1b glottic cancer. Transoral laser surgery showed similar oncologic results of open cordectomy, with better functional outcomes.