Patterns of Recurrence After Carbon Dioxide Laser Excision of Intraoral Squamous Cell Carcinoma

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Abstract
Objective: To examine retrospectively consecutive patients treated with carbon dioxide laser excision of intraoral squamous cell carcinoma for the patterns of recurrence based on the location of the initial primary tumor and on the tumor stage. Design: Retrospective chart review. Setting: Tertiary care center including a university hospital and a Veterans Affairs Medical Center. Procedures and Patients: Sixty-one procedures performed on 51 consecutive patients. The only patients not included were three who were unavailable for follow-up. The average follow-up was 32 months. If the patients whose follow-up was limited because of death are excluded, the average follow-up was 40 months. Main Outcome Measures: Incidence of recurrence, time to recurrence, development of second intraoral primary lesions or pulmonary metastases, and cause of death. Results: A nearly equal incidence of recurrence irrespective of site of lesion (tongue, 42%; floor of mouth, 40%; and other oral cavity sites, 45%). Determinate survival differed by stage. Patients with T1 lesions showed a determinate survival rate of 80%; those with T2 or T3 lesions had a determinate survival rate of 57%; and those treated for recurrent disease had a determinate survival rate of 44%. Conclusions: Carbon dioxide laser excision of intraoral squamous cell carcinoma is a useful, advantageous method, but it appears to offer no advantage for recurrence over standard methods. Appropriate management of neck disease in patients with intraoral squamous cell carcinoma must be carefully considered. Patients with this potentially aggressive form of cancer deserve long-term follow-up. (Arch Otolaryngol Head Neck Surg. 1995;121:1239-1244)