Investigation of Recurrence Rate and Associated Risk Factors of Laryngeal Squamous Cell Carcinoma in Patients Undergoing Transoral Laser Microsurgery: A Retrospective Cohort Study

Introduction: Laryngeal squamous cell carcinoma (SCC) remains a significant health challenge, with transoral laser microsurgery (TLM) emerging as a preferred treatment for early-stage disease. This retrospective cohort study investigates recurrence patterns, survival outcomes, and prognostic factors in patients treated with TLM, with a focus on the role of smoking exposure.Materials and Methods: A retrospective cohort study was conducted on ۱۴۲ patients with laryngeal SCC treated with TLM at Rasoul Akram Hospital (۲۰۱۶–۲۰۲۲). Patient demographics, tumor characteristics, smoking history (Pack-Years), and follow-up data were analyzed. Recurrence rates and survival were assessed using Kaplan-Meier analysis, and risk factors were evaluated using univariate logistic regression and Cox proportional hazards models.Results: The recurrence rate was ۲۶.۱% (n=۳۷), predominantly local (۷۰.۳%), with a median time to recurrence of ۱۵ months. Smoking exposure significantly correlated with recurrence risk (OR=۱.۰۲, ۹۵% CI: ۱.۰۰–۱.۰۳, p=۰.۰۲; HR=۱.۰۱, ۹۵% CI: ۱.۰۰–۱.۰۲, p=۰.۰۴). Kaplan-Meier analysis revealed reduced recurrence-free survival for patients with >۲۰ Pack-Years (p=۰.۰۴), while disease-free survival (DFS) probability was approximately ۰.۷۵ at ۸۰ months. No significant associations were found for age, sex, tumor stage, or comorbidities (all p>۰.۰۵), and no distant metastases were observed.Conclusions: TLM appears to be an effective treatment for early-stage laryngeal SCC in this cohort, with smoking identified as a critical modifiable risk factor for recurrence. The findings underscore the importance of smoking cessation interventions to enhance outcomes. Given the retrospective and single-center design, conclusions should be interpreted cautiously. Future multi-center studies with extended follow-up and molecular profiling are recommended.

کلیدواژه ها:

Laryngeal neoplasms ، Carcinoma ، Squamous Cell ، Laser therapy ، Recurrence ، Smoking ، Prognosis ، Risk factors