Long-term follow-up results of Nd: YAG laser treatment of premalignant and malignant (Stage I) squamous cell carcinoma of the oral cavity

BACKGROUND AND OBJECTIVES: Only few studies (none from India) have reported the role of Neodymium Yttrium-Aluminum-Garnet (Nd: YAG) laser for treatment of premalignant and stage I (T1N0M0) oral cancer. This study aimed to assess the outcome of Nd: YAG laser in the said lesions after a follow-up of 5 years. Design: Prospective study; Setting: a tertiary care hospital, North India. PATIENTS AND METHODS: Fifty biopsy proven patients of premalignant/malignant (Stage I) lesions oral cavity underwent Nd: YAG laser treatment after prior informed consent from January, 1997 to January, 2000. Patients were followed-up for 5 years. In addition to local recurrence, patient's mucosal response to laser in terms of pain, mastication, salivation, paraesthesias, facial expressions, and speech was also recorded. RESULTS: Twenty-seven patients had leukoplakia, 3 erythroplakia, 6 carcinoma in situ (CIS), and 14 stage I squamous cell carcinoma (SCC) of oral cavity. Four patients required repeat laserization for residual/ recurrent lesion and 15 patients were lost to follow-up. Recurrence free survival (RFS) at 5-years in premalignant and stage I SCC patients was 97.2 and 78.6%, respectively. A minimal persistent edema was observed in 6 (12%) patients at the end of 7th day, rest all tolerated the procedure well. CONCLUSIONS: The present study indicates that Nd: YAG laser is an effective and safe surgical option management of premalignant and malignant lesions of oral cavity.