Steiner Wolfgang, Ambrosch Petra, Rödel Ralph M W, Kron Martina
Department of Otorhinolaryngology, University of Göttingen, Göttingen, Germany.
Laryngoscope. 2004 Aug;114(8):1485-91. doi: 10.1097/00005537-200408000-00031.
To analyze the impact of anterior commissure involvement on local control, survival, and laryngeal preservation in patients with early glottic cancer (pT1a-pT2a) treated with unimodality laser microsurgical resection.
Retrospective review of 263 patients with early glottic cancer treated between 1986 and 1996.
Data on local control and overall survival rates were analyzed and calculated by the Kaplan-Meier method; the larynx preservation rates were given absolutely.
Among 158 patients presenting with T1a glottic cancer, the anterior commissure was involved in 28 cases; the 5-year local control rate was 84%, and the larynx preservation rate was 93%. In the 130 cases without anterior commissure involvement, the 5-year local control rate was 90.0% and the corresponding larynx preservation rate 99%. In the T1b category consisting of 30 patients, anterior commissure involvement was observed in 16 patients; the 5-year local control rate was 73%, and the larynx preservation rate was 88%. In the 14 cases without anterior commissure involvement, the 5-year local control rate was 92% and the corresponding larynx preservation rate 100%. Seventy-five patients had T2a glottic carcinomas, with normal vocal cord movement. The anterior commissure was involved in 45 cases; the 5-year local control rate was 79%, and the larynx preservation rate was 93%. In the 30 cases without anterior commissure involvement, the 5-year local control rate was 74.0% and the corresponding larynx preservation rate 97%.
This study shows the effectiveness of laser microsurgery for early glottic carcinoma regardless of anterior commissure involvement at presentation. This method can be performed as an outpatient procedure, even when conducting reresections.
分析前联合受累对接受单模态激光显微手术切除的早期声门癌（pT1a - pT2a）患者局部控制、生存及喉保留情况的影响。
对1986年至1996年间接受治疗的263例早期声门癌患者进行回顾性研究。
采用Kaplan - Meier法分析并计算局部控制率和总生存率；绝对给出喉保留率。
在158例T1a声门癌患者中，28例累及前联合；5年局部控制率为84%，喉保留率为93%。在130例未累及前联合的患者中，5年局部控制率为90.0%，相应喉保留率为99%。在由30例患者组成的T1b组中，16例观察到前联合受累；5年局部控制率为百分之73，喉保留率为88%。在14例未累及前联合的患者中，5年局部控制率为92%，相应喉保留率为100%。75例患者患有T2a声门癌，声带运动正常。45例累及前联合；5年局部控制率为79%，喉保留率为93%。在30例未累及前联合的患者中，5年局部控制率为74.0%，相应喉保留率为97%。
本研究表明，无论初诊时前联合是否受累，激光显微手术对早期声门癌均有效。即使进行再次切除，该方法也可作为门诊手术进行。
