Barbaro M, Rispoli G, Diaferia F, Stigliano S, Filipo R, Minni A
Università degli Studi di Roma "La Sapienza", Dipartimento di Neurologia ed Otorinolaringoiatria.
G Chir. 2008 Mar;29(3):74-8.
Advanced head & neck cancer, after a first treatment, has an high rate of relapse locally or in the lymph nodes. Aim of present study is to value the option and the results in salvage surgery of 62 patients (55 male, 7 female, mean age 53,2) with cancer of the larynx and pyriform sinus, previously treated by surgery or radiotherapy; 45,2% showed relapse on T side, 25,5% in the nodes, 29% both. During follow-up, 3,2% showed a second primitive cancer, 9,6% still present disease. Overall survival rate is 72,6% after 3 years (86,2% for early cancers, 54,5% in advanced ones), 50.6% after 5 years (65,5% for early, 36,4% in advanced). Laryngeal cancers presented better survival rate (54% at 5 years) after salvage surgery than ipopharynx (33% at 5 years). Therefore in ipophaynx cancers we think it is useful to programme aggressive treatment also in early cancer. In our experience in larynx recurrence suvracricoid surgery is really suitable.
晚期头颈癌在首次治疗后,局部或淋巴结复发率较高。本研究的目的是评估62例(55例男性,7例女性,平均年龄53.2岁)喉癌和梨状窝癌患者在挽救性手术中的选择和结果,这些患者先前已接受手术或放疗;45.2%在原发灶出现复发,25.5%在淋巴结复发,29%两者均复发。在随访期间,3.2%出现第二种原发性癌症,9.6%仍存在疾病。3年后总生存率为72.6%(早期癌症为86.2%,晚期癌症为54.5%),5年后为50.6%(早期为65.5%,晚期为36.4%)。喉癌在挽救性手术后的生存率(5年时为54%)高于下咽癌(5年时为33%)。因此,对于下咽癌,我们认为即使是早期癌症也进行积极治疗是有用的。根据我们在喉复发方面的经验,环状软骨上喉部分切除术确实适用。