Lima R A, Freitas E Q, Kligerman J, Dias F L, Barbosa M M, Sa G M, Santos I C, Farias T
Head and Neck Service, Hospital do Cancer, National Cancer Institute/INCA, Rio de Janeiro, Brazil.
Otolaryngol Head Neck Surg. 2001 Mar;124(3):258-60. doi: 10.1067/mhn.2001.113138.
To assess whether supracricoid laryngectomy with cricohiodoepiglottopexy could successfully reach the cure and preserve the voice in glottic laryngeal cancer, we studied 27 patients with T2/T3 squamous cell carcinoma of the larynx treated in our institution with cricohiodoepiglottopexy.
A retrospective analysis has been carried out between 1995 through 1997. We classified 11 patients as T2N0M0 and 16 patients as T3N0M0. Nineteen patients had bilateral selective lateral neck dissection, 3 patients had unilateral lateral neck dissection, and 5 patients had undissected neck. Survival was analyzed under the Kaplan-Meyer method.
Five patients had postoperative complications, 2 were treated with a total laryngectomy. The remaining 25 patients kept the normal airway, swallowing, and speech. None of the patients in the neck dissection group had neck metastasis. Two patients had recurrences, 1 with local recurrence was treated with a total laryngectomy and is alive without disease; the other patient had neck recurrence, was treated with radical neck dissection plus radiotherapy, and is dead of the disease. One patient had a second tumor in oropharynx treated with palliative radiotherapy and is dead of the disease. Three years disease-free survival was 75% for T2 and 79% for T3.
This technique is useful in the treatment of selected cases of T3/T2 glottic cancer regarding the extent of disease. The incidence of complications in need of a complete laryngectomy does not compromise the functionality of this technique. The survival is comparable to patients who submitted to total laryngectomy and near-total laryngectomy, regarding the extent of the lesion.
为评估环状软骨上喉切除术联合环舌骨会厌固定术能否成功治愈声门型喉癌并保留嗓音功能，我们对在我院接受环舌骨会厌固定术治疗的27例T2/T3期喉鳞状细胞癌患者进行了研究。
对1995年至1997年间的病例进行回顾性分析。我们将11例患者分类为T2N0M0，16例患者分类为T3N0M0。19例患者接受了双侧选择性颈侧区清扫术，3例患者接受了单侧颈侧区清扫术，5例患者未进行颈部清扫。采用Kaplan-Meier法分析生存率。
5例患者出现术后并发症，2例接受了全喉切除术。其余25例患者保持了正常的气道、吞咽和言语功能。颈清扫组患者均未发生颈部转移。2例患者出现复发，1例局部复发患者接受了全喉切除术，目前存活且无疾病；另1例患者出现颈部复发，接受了根治性颈清扫术加放疗，死于该疾病。1例患者口咽出现第二原发肿瘤，接受了姑息性放疗，死于该疾病。T2期患者的3年无病生存率为75%，T3期为79%。
就疾病范围而言，该技术对治疗部分T3/T2期声门型喉癌病例有效。需要行全喉切除术的并发症发生率并不影响该技术的功能。就病变范围而言，其生存率与接受全喉切除术和近全喉切除术的患者相当。
