Université Paris Descartes Sorbonne Paris Cité, HEGP, APHP, Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Paris.
Laryngoscope. 2013 Nov;123(11):2718-22. doi: 10.1002/lary.24246. Epub 2013 Jul 8.
OBJECTIVES/HYPOTHESIS: To analyze local failure following lateral pharyngotomy for selected untreated invasive squamous cell carcinoma (SCC) of the lateral oropharynx.
Retrospective review from a university teaching hospital.
Inception cohort of 91 patients who underwent lateral pharyngotomy for an isolated and previously untreated selected invasive carcinoma of the lateral oropharynx classified as T1 (26), T2 (47), T3 (11), and T4 (7). Induction chemotherapy, neck dissection, and postoperative radiation therapy were used in 91.2%, 94.5%, and 53.5% of patients.
The 5-year Kaplan-Meier estimate of local failure was 16.6% for T1, 19% for T2, 38.6% for T3, and 16.7% for T4 lesions (P = .46). In a logistic regression model, only positive margins of resection statistically increased (P = .01) the risk for local failure. In patients with safe margins of resection, the 5-year Kaplan-Meier estimate of local failure was 5.6% for T1 lesions, 10.7% for T2 lesions, 23.8% for T3 lesions, and 20% for T4 lesions (P = .4). Local failure had a significant impact on increased nodal failure (P = .001) and on reduced survival (P < .0001).
The lateral pharyngotomy approach should be viewed as a valuable oncologic alternative to both mandibulotomy and chemoradiation in patients with selected SCC of the lateral oropharynx.
目的/假设：分析侧咽切开术治疗未经治疗的侵袭性鳞状细胞癌（SCC）外侧口咽的局部失败。
来自一所大学教学医院的回顾性研究。
91 例患者接受侧咽切开术治疗孤立性、未经治疗的外侧口咽侵袭性 SCC，这些患者分为 T1（26 例）、T2（47 例）、T3（11 例）和 T4（7 例）。91.2%、94.5%和 53.5%的患者接受了诱导化疗、颈部清扫术和术后放疗。
T1、T2、T3 和 T4 病变的 5 年 Kaplan-Meier 局部失败估计值分别为 16.6%、19%、38.6%和 16.7%（P =.46）。在逻辑回归模型中，只有切缘阳性的患者局部失败的风险显著增加（P =.01）。在切缘安全的患者中，T1 病变的 5 年 Kaplan-Meier 局部失败估计值为 5.6%，T2 病变为 10.7%，T3 病变为 23.8%，T4 病变为 20%（P =.4）。局部失败与增加的淋巴结失败（P =.001）和降低的生存率（P <.0001）显著相关。
对于外侧口咽 SCC 的患者，侧咽切开术是一种有价值的替代下颌切开术和放化疗的肿瘤治疗方法。
