Márgenes histopatológicos positivos: ¿se relacionan siempre con recidiva tumoral en carcinoma glótico temprano?

Introduction: Squamous cell carcinoma of the larynx is one of the most common neoplasms in the head and neck region. In its early stages, it is characterized by a favorable oncological prognosis, leading to a management approach that focuses not only on the oncological aspect but also on the preservation of laryngeal functions. Transoral microsurgery with CO₂ laser (TML) demonstrates comparable effectiveness rates to open surgery and radiotherapy, and offers several advantages when compared to other treatment modalities. Objective: The aim of this study was to review the oncological outcomes achieved through the treatment of a series of early glottic tumors using TML in a tertiary university hospital. Methods: A retrospective review of medical records was conducted for patients diagnosed with early-stage squamous cell carcinoma of the larynx who underwent TML at a tertiary-level hospital between January 2012 and December 2019. Results: A total of 48 patients met the inclusion criteria: 91.7% males and 8.3% females. The mean age at diagnosis was 64.4 ± 13.3 years (min.: 36 / max.: 88). Among these, 83.3% had a history of smoking. The rate of organ preservation or laryngeal survival was 93.7%. Of the patients who did not experience tumor recurrence, 83% exhibited positive surgical margins. Conclusions: TML represents a therapeutic alternative for early-stage laryngeal tumors. Careful analysis of surgical margins is crucial, and close follow-up is recommended for all patients.