经口激光显微手术治疗 T3 声门型喉肿瘤：预后因素。

Transoral laser microsurgery for T3 laryngeal tumors: Prognostic factors.

机构信息

Department of Oto-Rhino-Laryngology, Hospital Clinic, University of Barcelona, Barcelona, Spain.

出版信息

Head Neck. 2010 Jul;32(7):929-38. doi: 10.1002/hed.21288.

DOI:10.1002/hed.21288

PMID:19953612

Abstract

BACKGROUND

The objective of this study was to evaluate the outcomes of transoral laser microsurgery (TLM) in T3 laryngeal carcinomas and to identify prognostic factors for survival and laryngeal preservation.

METHODS

This study aimed to provide a retrospective analysis of 147 consecutive patients, evaluating their overall survival, disease-specific survival, laryngectomy-free survival, and function preservation rate.

RESULTS

Five-year overall, disease-specific, and laryngectomy-free survivals were 53.1%, 70.2%, and 62.3%, respectively. Disease-specific survival differed between glottic and supraglottic tumors (86.3% vs 61.8%; p = .015). Function preservation was 65.5% in supraglottic and 49.1% in glottic tumors (p = .002). Disease-specific survival was not related to pre-epiglottic involvement, cord fixation, or focal cartilage infiltration (p > .05). Vocal cord fixation and cartilage infiltration were independent negative prognostic factors for organ preservation (odds ratio [OR] = 0.184; 95% confidence interval [CI] = 0.082-0.411; p = .000 and OR = 0.331; 95% CI = 0.139-0.789; p = .013, respectively).

CONCLUSION

Our conclusion is that TLM is a good alternative in a large number of T3 laryngeal tumors, with adequate survival and organ preservation rates above 60%.

摘要

背景

本研究旨在评估经口激光显微手术（TLM）治疗 T3 喉癌的疗效，并确定与生存和喉保留相关的预后因素。

方法

本研究回顾性分析了 147 例连续患者，评估了他们的总生存率、疾病特异性生存率、无喉切除术生存率和功能保留率。

结果

5 年总生存率、疾病特异性生存率和无喉切除术生存率分别为 53.1%、70.2%和 62.3%。声门型和声门上型肿瘤的疾病特异性生存率不同（86.3%比 61.8%；p =.015）。声门上型肿瘤的功能保留率为 65.5%，声门型肿瘤为 49.1%（p =.002）。疾病特异性生存率与会厌前间隙受累、声带固定或局灶性软骨浸润无关（p >.05）。声带固定和软骨浸润是器官保留的独立预后不良因素（比值比 [OR] = 0.184；95%置信区间 [CI] = 0.082-0.411；p =.000 和 OR = 0.331；95% CI = 0.139-0.789；p =.013）。