Department of Otorhinolaryngology, Head and Neck Surgery, University of Goettingen, Robert-Koch-Str. 40, 37075, Goettingen, Germany.
Eur Arch Otorhinolaryngol. 2013 Mar;270(3):1075-83. doi: 10.1007/s00405-012-2097-1. Epub 2012 Jul 5.
The objective of the study was to determine the oncological and functional results in patients after excision of tongue base carcinoma by transoral laser microsurgery. A retrospective unicenter study performed between 1986 and 2007. 82 patients with previously untreated squamous cell carcinoma of the tongue base (T1-4, N0-2, M0) underwent transoral laser surgery with curative intent. Stage distribution was as follows: stage I, 1 case (1 %): stage II, 6 cases (7 %): stage III, 14 cases (17 %): stage IV 61 cases (75 %). Main outcome measures are local control rate, overall survival, recurrence-free survival, complications, and feeding tube dependence. The results were Kaplan-Meier 5-year local control rate for all patients was 84 %. T-stage-related local control rate after 5 years was 94 % for stage I-II, 78 % for stage III and 81 % for stage IV. 5-year overall survival and recurrence-free survival were 59 and 69 %, respectively. UICC stage-related overall survival and recurrence-free survival were 70 and 86 % for stage I-II, 44 and 54 % for stage III and 58 and 69 % for stage IV. Postoperative bleeding at the primary tumor site occurred in 9 patients (11 %). Gastrostomy tubes remained in place permanently in 5 patients (6 %). Primary transoral laser microsurgery of tongue base carcinoma offers convincing oncological and functional results comparable to other treatment modalities, e.g., radio(chemo)therapy but has lower rates of morbidity.
本研究旨在确定经口激光微创手术切除舌根癌患者的肿瘤学和功能结果。这是一项 1986 年至 2007 年进行的回顾性单中心研究。82 例未经治疗的舌根鳞状细胞癌（T1-4，N0-2，M0）患者接受了以治愈为目的的经口激光手术。分期分布如下：Ⅰ期 1 例（1%）；Ⅱ期 6 例（7%）；Ⅲ期 14 例（17%）；Ⅳ期 61 例（75%）。主要观察指标为局部控制率、总生存率、无复发生存率、并发症和喂养管依赖性。结果采用 Kaplan-Meier 法，所有患者的 5 年局部控制率为 84%。T 分期相关的 5 年局部控制率为Ⅰ-Ⅱ期 94%，Ⅲ期 78%，Ⅳ期 81%。5 年总生存率和无复发生存率分别为 59%和 69%。UICC 分期相关的 5 年总生存率和无复发生存率分别为Ⅰ-Ⅱ期 70%和 86%，Ⅲ期 44%和 54%，Ⅳ期 58%和 69%。9 例（11%）患者在原发性肿瘤部位发生术后出血。5 例（6%）患者永久性留置胃造口管。原发性经口激光微创手术治疗舌根癌具有令人信服的肿瘤学和功能结果，与其他治疗方法（如放化疗）相当，但发病率较低。
