Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg Medical School, 91054 Erlangen, Germany.
J Surg Oncol. 2010 Feb 1;101(2):131-6. doi: 10.1002/jso.21449.
This study aims to assess the prognostic significance of free histopathologic margins in the surgical treatment of glottic cancer. Furthermore, it evaluates other prognostic factors regarding cases that receive surgical management for glottic lesions.
A retrospective case-series study was conducted at an academic tertiary referral center. The files of 1,314 cases that underwent primary surgical treatment for glottic cancer were studied. Various prognostic factors, including age, surgical procedure, T classification, N classification, histological grade, and status of margins were assessed in univariate and multivariate analyses. All variables were investigated for their association with local and regional disease control as well as disease specific and overall survival.
Status of margins significantly affected disease specific survival and local control regardless of tumor stage in this series. All other variables assessed in the univariate analysis for their association with survival were also found to be significant. However, status of surgical margins and N classification were the only significant variables in multivariate analysis.
The prognostic value of negative surgical margins for the treatment of glottic cancer cannot be overestimated. Responsibility of the surgeon during primary surgical treatment of glottic carcinomas is emphasized.
本研究旨在评估手术治疗声门型喉癌时无肿瘤组织学切缘的预后意义。此外,还评估了其他与接受声门型病变手术治疗的病例相关的预后因素。
在一家学术性三级转诊中心进行了回顾性病例系列研究。研究了 1314 例接受原发性手术治疗的声门型喉癌患者的档案。在单变量和多变量分析中,评估了包括年龄、手术方式、T 分类、N 分类、组织学分级以及切缘状态等各种预后因素。所有变量均被调查与局部和区域疾病控制以及疾病特异性和总生存率的相关性。
在本系列中,切缘状态无论肿瘤分期如何,均显著影响疾病特异性生存率和局部控制率。单变量分析中评估的所有其他与生存率相关的变量也被发现具有显著意义。然而,在多变量分析中,只有手术切缘状态和 N 分类是显著的变量。
对于声门型喉癌的治疗,阴性手术切缘的预后价值不容忽视。强调了外科医生在原发性声门型喉癌手术治疗中的责任。