Transoral laser microsurgery and open partial laryngectomy for limited-stage glottic cancer: a review of indications, oncologic and functional outcome, and prognosis.

For early-stage (T1-T2) glottic cancer, transoral laser microsurgery (TLM) and open partial laryngectomy (OPL) are primary organ-preserving options. This review compares their indications, outcomes, and prognostic factors based on a systematic literature analysis (1995-2025). TLM and OPL show comparable oncologic efficacy for local control and survival, but TLM generally offers superior voice preservation, fewer complications, and faster recovery, making it the preferred approach for well-exposed lesions. OPL remains essential for tumors involving the anterior commissure or with poor endoscopic exposure. Functional outcomes and recurrence risk are closely tied to resection extent and margin status. Key prognostic factors include anterior commissure involvement, surgical margins, and cordectomy type. Both techniques achieve high laryngeal preservation rates, yet their functional profiles differ: TLM favors phonatory outcomes, while OPL provides stable airway and swallowing after rehabilitation. Individualized treatment should integrate tumor characteristics, surgical expertise, and patient priorities to optimize the balance between oncologic control and function preservation.