Preuss S F, Cramer K, Klussmann J P, Eckel H E, Guntinas-Lichius O
Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany.
Eur J Surg Oncol. 2009 Mar;35(3):235-40. doi: 10.1016/j.ejso.2008.01.012. Epub 2008 Feb 20.
Curative treatment options for laryngeal carcinoma include primary radiation therapy, open surgical techniques and transoral laser surgery (TLS). In the last decade, TLS has become an important tool in the treatment of laryngeal cancer and has become the standard approach in many institutions. The aim of this study was to review the experience of a single center institution with TLS for early and advanced laryngeal cancer.
We retrospectively analyzed 275 patients who underwent TLS in regard to the survival outcome and surgical complications.
The 5-year disease-free survival estimate was 90.3% and the 10-year disease-free survival estimate was 88.2%. The 5-year larynx preservation rate estimate was 88.2% and the 10-year larynx preservation rate estimate was 87.3%. The disease-free survival was significantly worsened by the variables T and N (p=0.0003; p<0.001, respectively). Two percent of all patients required intraoperative tracheostomy and the rate of minor postoperative complications was 17%. There were no fatal complications.
We conclude that TLS is a valid treatment method for early laryngeal carcinoma. Selected cases of advanced carcinomas may also benefit from TLS.
喉癌的根治性治疗方案包括原发性放射治疗、开放手术技术和经口激光手术（TLS）。在过去十年中，TLS已成为喉癌治疗的一项重要工具，并在许多机构成为标准方法。本研究的目的是回顾一家单中心机构使用TLS治疗早期和晚期喉癌的经验。
我们回顾性分析了275例行TLS治疗患者的生存结果和手术并发症。
5年无病生存率估计为90.3%，10年无病生存率估计为88.2%。5年喉保留率估计为88.2%，10年喉保留率估计为87.3%。无病生存率因T和N变量而显著恶化（分别为p = 0.0003；p < 0.001）。所有患者中有2%需要术中气管切开，术后轻微并发症发生率为17%。无致命并发症。
我们得出结论，TLS是早期喉癌的一种有效治疗方法。部分晚期癌病例也可能从TLS中获益。
