Shvero Jacob, Shvili Itzhak, Mizrachi Aviram, Shpitzer Thomas, Nageris Benny, Koren Rumelia, Hadar Tuvia
Department of Otolaryngology-Head and Neck Surgery, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Laryngoscope. 2009 Jun;119(6):1116-9. doi: 10.1002/lary.20138.
OBJECTIVES/HYPOTHESIS: The posterior commissure is an uncommon site of glottic carcinoma. The aim of the study was to compare the clinical and prognostic characteristics of glottic carcinoma of the posterior commissure and the vocal cords.
Retrospective case control study.
The study group consisted of 40 patients aged 32 to 84 years (mean, 62.7 +/- 10.7) diagnosed with T1 glottic carcinoma involving the posterior commissure from 1960 to 2008. Data on clinical features and outcome were collected from the medical files and compared with the data for 42 patients aged 30 to 87 years (mean, 64.4 +/- 11.8) with T1 vocal cord carcinoma.
: There were no significant differences in clinical characteristics between the groups except for the higher rate of smokers among the patients with vocal cord carcinoma (95% vs. 65%, P = .01). All patients were treated primarily with radiotherapy. Disease-free survival in the posterior commissure carcinoma group was 76.1% after 5 years and 72.3% after 10 years, and in the vocal cord carcinoma group, 95% after 5 and 10 years (P = .012). The risk of recurrence was higher when the tumor involved the posterior commissure (hazard ratio, 8.78; 95% CI, 1.12-68.5, P = .038).
T1 glottic carcinoma involving the posterior commissure has a more aggressive biological behavior and a worse prognosis than T1 glottic carcinoma of the vocal cords. Smoking, which is an important pathogenetic factor in vocal cord carcinoma, plays a lesser role in posterior commissure carcinoma. Laryngoscope, 2009.
目的/假设：后联合是声门癌的一个不常见部位。本研究的目的是比较后联合和声带上声门癌的临床及预后特征。
回顾性病例对照研究。
研究组由1960年至2008年诊断为累及后联合的T1声门癌的40例患者组成，年龄32至84岁（平均62.7±10.7岁）。从病历中收集临床特征和结局数据，并与42例年龄30至87岁（平均64.4±11.8岁）的T1声带癌患者的数据进行比较。
两组临床特征无显著差异，除声带癌患者中吸烟者比例较高（95%对65%，P = .01）。所有患者均主要接受放疗。后联合癌组5年后无病生存率为76.1%，10年后为72.3%；声带癌组5年和1年后均为95%（P = .012）。肿瘤累及后联合时复发风险更高（风险比，8.78；95%可信区间，1.12 - 68.5，P = .038）。
累及后联合的T1声门癌比声带T1声门癌具有更具侵袭性的生物学行为和更差的预后。吸烟是声带癌的重要致病因素，在后联合癌中作用较小。《喉镜》，2009年。
