经口激光显微手术治疗未经治疗的声门癌。
Transoral laser microsurgery for untreated glottic carcinoma.
作者信息
Grant David G, Salassa John R, Hinni Michael L, Pearson Bruce W, Hayden Richard E, Perry William C
机构信息
Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Jacksonville, Florida 32224, USA.
出版信息
Otolaryngol Head Neck Surg. 2007 Sep;137(3):482-6. doi: 10.1016/j.otohns.2007.05.064.
OBJECTIVES
To report the oncology and functional outcomes of transoral laser microsurgery (TLM) for untreated glottic carcinoma.
STUDY DESIGN
A 2 center prospective case series analysis.
SETTING
Academic, tertiary referral centers.
RESULTS
Seventy-six patients underwent TLM. Pathologic T stages were: T1, 45 (59%); T2, 21 (28%); T3, 5 (7%); and T4, 5 (7%). Five (7%) patients had neck dissections. Five (7%) patients received adjuvant radiotherapy. Mean follow-up was 42 months. Respective T1 and T2 5-year Kaplan-Meier estimates were: local control, 90% and 93%; loco-regional control, 90% and 93%; disease specific survival, 90% and 93%; and overall survival, 94% and 93%. The average hospital stay was 2 days. Two (3%) patients experienced major complications. The overall laryngeal preservation rate was 95% (72 of 76).
CONCLUSIONS
TLM is a safe and effective treatment in select carcinoma of the glottic larynx. Low morbidity and mortality and short periods of hospitalization make TLM an attractive therapeutic option.
SIGNIFICANCE
TLM is an emerging strategy in the treatment of laryngeal cancer.
目的
报告经口激光显微手术（TLM）治疗未经治疗的声门癌的肿瘤学及功能学结果。
研究设计
一项2中心前瞻性病例系列分析。
研究地点
学术性三级转诊中心。
结果
76例患者接受了TLM治疗。病理T分期为：T1期45例（59%）；T2期21例（28%）；T3期5例（7%）；T4期5例（7%）。5例（7%）患者接受了颈部清扫术。5例（7%）患者接受了辅助放疗。平均随访时间为42个月。T1期和T2期各自的5年Kaplan-Meier估计值分别为：局部控制率90%和93%；局部区域控制率90%和93%；疾病特异性生存率90%和93%；总生存率94%和93%。平均住院时间为2天。2例（3%）患者发生了严重并发症。总体喉保留率为95%（76例中的72例）。
结论
TLM是治疗声门喉癌的一种安全有效的方法。低发病率、低死亡率和短住院时间使TLM成为一种有吸引力治疗选择。
意义
TLM是喉癌治疗中一种新兴的策略。
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