Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

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

Document Type : Original

Authors
Mohammad Amin Zaeim Yekeh
Aslan Ahmadi
Pegah Alizade Pahlavan
Mohammad Mahdi Salem
ENT and Head and Neck Research Center and Department, The Five Senses Health Institute, School of Medicine, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
10.22038/ijorl.2025.90331.4018
Abstract
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 142 patients with laryngeal SCC treated with TLM at Rasoul Akram Hospital (2016–2022). 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 26.1% (n=37), predominantly local (70.3%), with a median time to recurrence of 15 months. Smoking exposure significantly correlated with recurrence risk (OR=1.02, 95% CI: 1.00–1.03, p=0.02; HR=1.01, 95% CI: 1.00–1.02, p=0.04). Kaplan-Meier analysis revealed reduced recurrence-free survival for patients with >20 Pack-Years (p=0.04), while disease-free survival (DFS) probability was approximately 0.75 at 80 months. No significant associations were found for age, sex, tumor stage, or comorbidities (all p>0.05), 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.
Keywords
Laryngeal Neoplasms
Carcinoma
Squamous Cell
Laser Therapy
Recurrence
Smoking
Prognosis
Risk Factors
Subjects
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Iranian Journal of Otorhinolaryngology
Volume 38, Issue 1
January and February 2026
Pages 19-27