The utility of second-look operation after laser microresection of glottic carcinoma involving the anterior commissure

Objectives/Hypothesis: Transoral laser microsurgery for the treatment of glottic carcinoma with anterior commissure (A‐com) involvement is associated with a high rate of recurrence. We prospectively evaluated the outcomes of laser microsurgery and the efficacy of second‐look operation in these patients. Study Design: Prospective evaluation. Methods: Twenty‐seven patients with glottic carcinomas involving the A‐com underwent transoral laser microresection. Twenty‐five patients underwent second‐look operations 3 months after laser surgery. Results: After transoral laser microresection, all patients achieved microscopic clear resection margins. Local recurrence was found in 7 of 27 patients (25.9%). Regional recurrence was found in two patients. Patients with recurrences underwent laser re‐resection or neck dissection; four received radiotherapy, two lost their larynxes, and three died of disease. At second‐look operation, early local recurrence was found in two patients, and anterior glottic webs and granulomas causing dysphonia were treated in 8 and 11 patients, respectively. Conclusions: Laser microsurgery is an effective treatment modality in early glottic cancer with A‐com involvement but is still associated with a high rate of recurrence. Second‐look operation may help detect early local recurrence and treat postoperative airway or voice problems.