226例T3期喉癌患者经口激光显微手术治疗后的结果。
Results of 226 patients with T3 laryngeal carcinoma after treatment with transoral laser microsurgery.
作者信息
Canis Martin, Ihler Friedrich, Martin Alexios, Wolff Hendrik A, Matthias Christoph, Steiner Wolfgang
机构信息
Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Germany.
出版信息
Head Neck. 2014 May;36(5):652-9. doi: 10.1002/hed.23338. Epub 2013 Jul 2.
BACKGROUND
The purpose of this study was to assess the feasibility of transoral laser microsurgery (TLM) in treatment of pT3 laryngeal cancer.
METHODS
We conducted a retrospective case series study of 226 patients with pT3 glottic (n = 122; 54%) or supraglottic laryngeal carcinoma (n = 104; 46%). All patients were treated by TLM in combination with neck dissection (63%) and with postoperative radiotherapy (18%). Our main outcome measures were local control, organ preservation, functional outcome, overall survival, recurrence-free survival, and disease-specific survival.
RESULTS
Median follow-up period was 57.8 months. The 5-year organ-preservation and local control rates for all patients were 87% and 71.4%, respectively. The 5-year overall, recurrence-free, and disease-specific survival were 64.4%, 63.0%, and 83.3%, respectively.
CONCLUSION
Results are comparable to partial or total laryngectomy, while being superior to primary chemo(radio)therapy. TLM results in low morbidity, rapid recovery, and good function and can be a valid option for organ-preserving surgery of pT3 glottic and supraglottic cancer.
背景
本研究旨在评估经口激光显微手术（TLM）治疗pT3期喉癌的可行性。
方法
我们对226例pT3期声门型（n = 122；54%）或声门上型喉癌（n = 104；46%）患者进行了一项回顾性病例系列研究。所有患者均接受TLM联合颈部清扫术（63%）和术后放疗（18%）治疗。我们的主要观察指标为局部控制、器官保留、功能结局、总生存、无复发生存和疾病特异性生存。
结果
中位随访期为57.8个月。所有患者的5年器官保留率和局部控制率分别为87%和71.4%。5年总生存、无复发生存和疾病特异性生存分别为64.4%、63.0%和83.3%。
结论
结果与部分或全喉切除术相当，同时优于单纯化疗（放疗）。TLM导致的发病率低、恢复快且功能良好，对于pT3期声门型和声门上型癌症的器官保留手术来说是一个有效的选择。
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