Sun D-I, Cho K-J, Cho J-H, Joo Y-H, Jung C-K, Kim M-S
Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seocho-Gu, Seoul, Korea.
Clin Otolaryngol. 2009 Apr;34(2):132-9. doi: 10.1111/j.1749-4486.2008.01854.x.
To validate pathologically whether supracricoid partial laryngectomy is an oncologically sound procedure in cases with invasion of the thyroid cartilage, paraglottic space, pre-epiglottic space, anterior commissure, or subglottis.
A retrospective review of case notes was performed.
Patients treated at a single institute in the Republic of Korea.
Sixty-three patients who underwent supracricoid partial laryngectomy for laryngeal squamous cell carcinoma between June 1994 and May 2005 who were followed for at least 2 years.
Local control and overall survival rates. Pathological invasion of the thyroid cartilage, anterior commissure, pre-epiglottic space, paraglottic space, or subglottis was also investigated as a cause of recurrence. Prognostic factors for local control and survival were evaluated with univariate and multivariate models.
Invasion of the anterior commissure, paraglottic space, thyroid cartilage, pre-epiglottic space, or subglottis had no significant impact on the recurrence or overall survival rates. The presence of a positive resection margin was significantly associated with recurrence in the univariate and multivariate analyses (P = 0.026, 0.028, respectively). When considering the prognostic factors influencing survival, the univariate analysis showed that N stage, a positive resection margin and recurrence had significant influences on the overall survival rate (P = 0.010, 0.0004 and 0.000 respectively). In the multivariate analysis, only recurrence affected the survival rate (P = 0.002).
Supracricoid partial laryngectomy can be used with oncological safety in selected cases of laryngeal cancer with invasion of the anterior commissure, thyroid cartilage, pre-epiglottic space, paraglottic space, or subglottis.
通过病理学方法验证在甲状腺软骨、声门旁间隙、会厌前间隙、前联合或声门下区受侵的病例中，环状软骨上部分喉切除术在肿瘤学方面是否为一种合理的手术方式。
对病例记录进行回顾性研究。
韩国一家机构接受治疗的患者。
1994年6月至2005年5月间因喉鳞状细胞癌接受环状软骨上部分喉切除术且随访至少2年的63例患者。
局部控制率和总生存率。还对甲状腺软骨、前联合、会厌前间隙、声门旁间隙或声门下区的病理侵犯作为复发原因进行了研究。采用单因素和多因素模型评估局部控制和生存的预后因素。
前联合、声门旁间隙、甲状腺软骨、会厌前间隙或声门下区受侵对复发率或总生存率无显著影响。在单因素和多因素分析中，切缘阳性与复发显著相关（分别为P = 0.026、0.028）。在考虑影响生存的预后因素时，单因素分析显示N分期、切缘阳性和复发对总生存率有显著影响（分别为P = 0.010、0.0004和0.000）。在多因素分析中，只有复发影响生存率（P = 0.002）。
对于前联合、甲状腺软骨、会厌前间隙、声门旁间隙或声门下区受侵的特定喉癌病例，环状软骨上部分喉切除术可安全用于肿瘤治疗。
