Strojan P, Smid L, Cizmarevic B, Zagar T, Auersperg M
Department of Radiation Oncology, Institute of Oncology, Zaloska 2, SI-1000 Ljubljana, Slovenia.
Eur J Surg Oncol. 2006 Nov;32(9):984-8. doi: 10.1016/j.ejso.2006.03.025. Epub 2006 Apr 19.
Verrucous carcinoma (VC) of the larynx is a rare variant of well-differentiated squamous cell carcinoma, characterized by locally invasive, exophytic warty growth. The purpose of the present study was to evaluate the experience with this rare disease in Slovenia over a 23-year period and to weigh the potential for cure of different treatment options against the functional outcome.
The databases of the Cancer Registry of Slovenia as well as of the registries of all three departments licensed for the treatment of laryngeal cancer in the country were used for the identification of patients. Presentation, diagnosis, treatment and outcome were reviewed retrospectively.
From 1980 to 2002, 30 patients were diagnosed with VC of the larynx, representing 1.23% of all laryngeal malignancies. The most frequent site of origin was the glottis. Twenty-three patients had surgery (functional 13; total laryngectomy 10), three patients had radiotherapy, and a combination of irradiation and concomitant chemotherapy was used in four patients. Only one tumor recurred, six months after primary radiation treatment, but was successfully salvaged with a total laryngectomy. The 5-year overall survival rate of 75% was not significantly different from an age- and sex-matched cohort from the Slovenian population (P=0.071).
In VC of the larynx, determination of treatment options should be dictated by voice preservation strategies. Surgery remains the gold standard of treatment. However, concomitant radiochemotherapy emerges as an attractive alternative to mutilating surgical procedures.
喉疣状癌（VC）是一种罕见的高分化鳞状细胞癌变体，其特征为局部浸润性、外生性疣状生长。本研究的目的是评估斯洛文尼亚在23年期间对这种罕见疾病的治疗经验，并权衡不同治疗方案的治愈潜力与功能结局。
使用斯洛文尼亚癌症登记处以及该国所有三个获得喉癌治疗许可部门的登记处数据库来识别患者。对患者的临床表现、诊断、治疗和结局进行回顾性分析。
1980年至2002年期间，30例患者被诊断为喉疣状癌，占所有喉恶性肿瘤的1.23%。最常见的起源部位是声门。23例患者接受了手术（功能性手术13例；全喉切除术10例），3例患者接受了放疗，4例患者采用了放疗与同步化疗相结合的治疗方法。仅1例肿瘤在初次放疗后6个月复发，但通过全喉切除术成功挽救。75%的5年总生存率与斯洛文尼亚人口中年龄和性别匹配的队列相比无显著差异（P = 0.071）。
在喉疣状癌中，治疗方案的确定应以保留嗓音策略为指导。手术仍然是治疗的金标准。然而，同步放化疗作为一种替代致残性手术的方法颇具吸引力。
