Yu Wen-Bin, Zeng Zong-Yuan, Chen Fu-Jin, Peng Han-Wei
State Key Laboratory of Oncology in Southern China, Guangzhou, Guangdong 510060, P. R. China.
Ai Zheng. 2006 Jan;25(1):85-7.
BACKGROUND & OBJECTIVE: Clinical treatment of stage T3 glottic laryngeal cancer still remains controversial. This study was to explore the influences of different treatment modalities, lymph node metastasis, and positive margin on prognosis of stage T3 glottic cancer.
Records of 65 stage T3 glottic cancer patients, treated in Cancer Center of Sun Yat-sen University from Jan. 1, 1990 to Dec. 30, 1998, were retrospectively analyzed. The influences of different treatments, lymph node metastasis, and positive margin on survival of the patients were analyzed.
The 3- and 5-year overall survival rates were 75.47% and 65.07%. No significant difference was found among surgery alone, radiotherapy alone, and surgery plus adjuvant radiotherapy groups (P=0.914), between partial laryngectomy and total laryngectomy groups (P=0.710), and between positive margin and negative margin groups (P=0.176). The lymph node metastasis rate was 18.5%, and the occult lymph node metastasis rate was 10.8%. Lymph node metastasis was a poor prognostic factor (P<0.001).
The influences of different treatments on survival of stage T3 glottic cancer patients are similar, and the effects of partial laryngectomy and total laryngectomy are also similar. Lymph node metastasis affects prognosis, and wait-and-see is recommended to cN0 patients. The survival of patients with positive margin after postoperative radiotherapy is similar to that of patients with negative margin.
T3期声门型喉癌的临床治疗仍存在争议。本研究旨在探讨不同治疗方式、淋巴结转移及手术切缘阳性对T3期声门型喉癌预后的影响。
回顾性分析1990年1月1日至1998年12月30日在中山大学肿瘤防治中心接受治疗的65例T3期声门型喉癌患者的病历。分析不同治疗方式、淋巴结转移及手术切缘阳性对患者生存的影响。
3年和5年总生存率分别为75.47%和65.07%。单纯手术、单纯放疗及手术加辅助放疗组之间（P = 0.914）、部分喉切除术与全喉切除术组之间（P = 0.710）以及手术切缘阳性与阴性组之间（P = 0.176）均未发现显著差异。淋巴结转移率为18.5%，隐匿性淋巴结转移率为10.8%。淋巴结转移是不良预后因素（P < 0.001）。
不同治疗方式对T3期声门型喉癌患者生存的影响相似，部分喉切除术与全喉切除术的效果也相似。淋巴结转移影响预后，对于cN0患者建议观察等待。术后放疗切缘阳性患者的生存与切缘阴性患者相似。
