Shah J P, Loree T R, Kowalski L
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
Head Neck. 1990 Jul-Aug;12(4):326-31. doi: 10.1002/hed.2880120409.
A consecutive series of 28 patients treated by conservation surgery of the larynx for radiation-failure, recurrent rT1 and T2 (postradiotherapy staging) glottic squamous cell carcinoma treated at Memorial Sloan-Kettering Cancer Center from 1966 to 1983 is reviewed. The majority of patients were men with the age ranging from 46 to 76 years. The disease-free interval ranged from 0 to 113 months (median, 8.5 months). The stage at presentation was rT1 in 25 patients and rT2 in 3 patients. Surgery consisted of cordectomy (7 patients), hemilaryngectomy (18), and extended hemilaryngectomy (3). There was no operative mortality. Local recurrence developed in 8 patients (28.5%), cervical metastasis in 2, and distant metastasis in 1. Only 3 patients were salvaged by further treatment. The rate of local control was influenced by positive surgical margins. Overall, voice preservation was achieved in 75% of patients. The ultimate local control was 82.1% during a follow-up period that ranged from 1.3 to 16.7 years (median, 6.3 years). The actuarial survival at 5 and 10 years was 73% and 71% following conservation surgery of the larynx.
回顾了1966年至1983年在纪念斯隆凯特琳癌症中心接受喉部保喉手术治疗的一系列连续28例因放疗失败、复发性rT1和T2（放疗后分期）声门鳞状细胞癌患者。大多数患者为男性，年龄在46至76岁之间。无病间期为0至113个月（中位数为8.5个月）。初诊时分期为rT1的患者有25例，rT2的患者有3例。手术方式包括声带切除术（7例）、半喉切除术（18例）和扩大半喉切除术（3例）。无手术死亡病例。8例患者（28.5%）出现局部复发，2例出现颈部转移，1例出现远处转移。只有3例患者通过进一步治疗挽救。局部控制率受手术切缘阳性的影响。总体而言，75%的患者实现了声音保留。在1.3至16.7年（中位数为6.3年）的随访期内，最终局部控制率为82.1%。喉部保喉手术后5年和10年的精算生存率分别为73%和71%。
