二氧化碳激光内镜下水平部分喉切除术治疗声门上型鳞状细胞癌
Endoscopic horizontal partial laryngectomy by CO(2) laser in the management of supraglottic squamous cell carcinoma.
作者信息
Bussu Francesco, Almadori Giovanni, De Corso Eugenio, Rizzo Davide, Rigante Mario, Parrilla Claudio, Valentini Vincenzo, Paludetti Gaetano
机构信息
Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy.
出版信息
Head Neck. 2009 Sep;31(9):1196-206. doi: 10.1002/hed.21085.
BACKGROUND
The objective of this study was to evaluate the results of endoscopic horizontal supraglottic laryngectomy (EHSL) by CO(2) laser.
METHODS
Between 1996 and 2005, 78 patients underwent a horizontal supraglottic laryngectomy operation (HSL) with an external approach and 70 underwent laser EHSL, as treatment for supraglottic laryngeal squamous cell carcinoma (LSCC). We evaluated oncological endpoints, comparing the external and the endoscopic approach.
RESULTS
Among patients primarily treated by EHSL, the 5-year disease-specific survival (DSS) was 89% (vs 80% in the external approach group). Statistical analysis did not reveal significant differences between the 2 groups as for survival nor for organ preservation. The most significant clinical predictor for DSS is neck relapse (p < .0001).
CONCLUSIONS
This study confirms the effectiveness of laser EHSL in which oncological outcome is similar to the external approach and functional results are probably better. Neck management in this setting is fundamental to warrant the best survival.
背景
本研究的目的是评估二氧化碳激光内镜下水平上喉切除术（EHSL）的效果。
方法
1996年至2005年间，78例患者接受了开放性水平上喉切除术（HSL），70例接受了激光EHSL，作为声门上喉鳞状细胞癌（LSCC）的治疗方法。我们评估了肿瘤学终点，比较了开放性手术和内镜手术方法。
结果
在主要接受EHSL治疗的患者中，5年疾病特异性生存率（DSS）为89%（开放性手术组为80%）。统计学分析未显示两组在生存率和器官保留方面存在显著差异。DSS最显著的临床预测因素是颈部复发（p <.0001）。
结论
本研究证实了激光EHSL的有效性，其肿瘤学结果与开放性手术相似，功能结果可能更好。在这种情况下，颈部处理对于保证最佳生存率至关重要。
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