Barry Béatrix, Baujat Bertrand, Albert Sébastien, Nallet Emmanuel, Depondt Joël, Guedon Charles, Gehanno Pierre
Department of Otorhinolaryngology, Bichat Teaching Hospital, Paris, France.
Laryngoscope. 2003 Feb;113(2):373-6. doi: 10.1097/00005537-200302000-00031.
OBJECTIVES/HYPOTHESIS: Advanced carcinoma of the tongue can require total glossectomy. Although radiation therapy is of limited efficacy in T3 and T4 tumors involving the base of the tongue, many surgeons are reluctant to suggest highly mutilating surgery.
Retrospective cohort study.
We compared early postoperative complications, hospital stay duration, function, and oncological outcomes in patients who underwent total glossectomy without laryngectomy as first-line or salvage therapy.
Postoperative course and functional outcomes were similar in the two groups. Overall survival was 32% at 3 years and 21% at 5 years. The risk factors for shorter survival were positive margins of resection (P =.002) and tumor spread into the mandible (P =.04). Salvage surgery was not associated with significantly lower survival (P =.09 [NS]).
Postoperative morbidity and functional outcomes are similar after first-line and salvage total glossectomy without laryngectomy. Local tumor control is the main factor influencing survival.
目的/假设：晚期舌癌可能需要进行全舌切除术。尽管放射治疗对累及舌根的T3和T4肿瘤疗效有限，但许多外科医生不愿建议进行创伤性极大的手术。
回顾性队列研究。
我们比较了接受全舌切除术且未行喉切除术作为一线治疗或挽救性治疗的患者的术后早期并发症、住院时间、功能和肿瘤学结局。
两组的术后病程和功能结局相似。3年总生存率为32%，5年为21%。生存时间较短的危险因素为切缘阳性（P = 0.002）和肿瘤侵犯下颌骨（P = 0.04）。挽救性手术与生存率显著降低无关（P = 0.09[无统计学意义]）。
在未行喉切除术的一线和挽救性全舌切除术后，术后发病率和功能结局相似。局部肿瘤控制是影响生存的主要因素。
