Supraglottic CO laser laryngectomy: Real-world outcomes from a single-institution cohort.

[INTRODUCTION] Supraglottic laryngeal cancers often present at advanced stages and carry poorer prognoses than glottic tumors. Transoral CO₂ laser microsurgery (TOLMS) offers a minimally invasive, organ-preserving alternative, but functional morbidity remains a challenge.

[MATERIALS & METHODS] To evaluate oncological and functional outcomes of supraglottic partial CO₂ laser laryngectomy in a single-institution. Thirty-six patients treated with supraglottic partial CO₂ laser laryngectomy were analyzed retrospectively. Demographic, clinical, surgical, oncological, and functional outcomes were reviewed. Survival was analyzed using Kaplan-Meier estimates, and differences were tested with the log-rank test.

[RESULTS] Mean age was 64 ± 8 years, with 83.3% male patients. Most tumors were pT2 (47.2%). Free surgical margins were achieved in 69.4% of cases. Three-year overall and disease-specific survival rates were 63.9% and 69.4%, respectively. Persistent gastrostomy dependence was observed in 3 (8.3%) patients. Tracheostomy was required in 4 (11.1%) patients, with persistent tracheostomy required in just 1 (2.8%) patient.

[CONCLUSIONS] Supraglottic partial CO₂ laser laryngectomy offers oncologic outcomes comparable to published series. However, functional morbidity remains significant and warrants careful patient selection and preoperative counseling.