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声门上型喉部分切除术的肿瘤学结果。

Oncologic outcomes after supracricoid partial laryngectomy.

机构信息

La Paz University Hospital, Madrid, Spain.

出版信息

Otolaryngol Head Neck Surg. 2011 Jun;144(6):910-4. doi: 10.1177/0194599811400368. Epub 2011 Mar 1.

Abstract

OBJECTIVE

To review the oncologic outcomes of a series of supracricoid partial laryngectomy.

DESIGN

Case series with chart review.

SETTING

La Paz University Hospital, Madrid, Spain.

PATIENTS

Forty-one patients with glottic or supraglottic squamous cell carcinoma who underwent supracricoid partial laryngectomy between 1998 and 2008 at the authors' institution.

MAIN OUTCOME MEASURE

Local control rate, specific-disease survival rate, and overall survival rate.

RESULTS

All patients were male, with a mean age of 56 years (range, 38-71 years). Forty-one percent of tumors were classified as locally advanced carcinomas (T3-T4). Thirty-three patients (80%) underwent supracricoid laryngectomy with cricohyoidoepiglottopexy. Epiglottis was resected in the remaining 8 patients. One patient died in the immediate postoperative period because of cardiac tamponade, 6 developed pneumonia, 2 had a postoperative bleeding that required reintervention, and 2 developed pharyngocutaneous fistula. The median follow-up period was 43 months. More than 85% of the patients completed more than 2 years of follow-up. Five-year actuarial local control rate was 80%, being 92% for T1-T2 tumors and 67% for locally advanced tumors. Thirty-five patients (85%) preserved their larynx. The 6 patients who underwent total laryngectomy had a local recurrence or a regional recurrence that infiltrated the larynx. No laryngectomy was performed for functional reasons.

CONCLUSION

Supracricoid partial laryngectomy is an oncologically safe procedure to preserve laryngeal functions in selected patients with glottic and supraglottic carcinomas.

摘要

目的

回顾一系列环状软骨上部分喉切除术的肿瘤学结果。

设计

病例系列及图表回顾。

地点

西班牙马德里拉巴斯大学医院。

患者

1998 年至 2008 年期间,作者所在机构共 41 例声门或声门上型鳞状细胞癌患者接受了环状软骨上部分喉切除术。

主要观察指标

局部控制率、特定疾病生存率和总生存率。

结果

所有患者均为男性,平均年龄 56 岁(范围,38-71 岁)。41%的肿瘤被分类为局部晚期癌(T3-T4)。33 例(80%)患者行环状软骨喉部分切除术加环舌会厌固定术。其余 8 例患者切除了会厌。1 例患者因心脏压塞在术后即刻死亡,6 例发生肺炎,2 例发生术后出血需再次干预,2 例发生咽皮瘘。中位随访时间为 43 个月。超过 85%的患者完成了 2 年以上的随访。5 年的局部控制率为 80%,T1-T2 肿瘤为 92%,局部晚期肿瘤为 67%。35 例(85%)患者保留了他们的喉咙。6 例行全喉切除术的患者发生了局部或区域复发,并侵犯了喉咙。因功能原因未行喉切除术。

结论

环状软骨上部分喉切除术是一种保留声门和声门上型癌患者喉功能的肿瘤学安全手术。

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