Canis Martin, Ihler Friedrich, Martin Alexios, Wolff Hendrik A, Matthias Christoph, Steiner Wolfgang
Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Germany.
Head Neck. 2014 May;36(5):652-9. doi: 10.1002/hed.23338. Epub 2013 Jul 2.
The purpose of this study was to assess the feasibility of transoral laser microsurgery (TLM) in treatment of pT3 laryngeal cancer.
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.
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.
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.
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。
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。
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。
