多中心回顾性系列研究中复发性喉鳞状细胞癌手术挽救的肿瘤学结果：环状软骨上部分喉切除术的新作用
Oncologic results of the surgical salvage of recurrent laryngeal squamous cell carcinoma in a multicentric retrospective series: emerging role of supracricoid partial laryngectomy.
作者信息
de Vincentiis Marco, De Virgilio Armando, Bussu Francesco, Gallus Roberto, Gallo Andrea, Bastanza Giovanni, Parrilla Claudio, Greco Antonio, Galli Jacopo, Turchetta Rosaria, Almadori Giovanni, Pagliuca Giulio, Valentini Vincenzo, Paludetti Gaetano
机构信息
Department of Sensorial Organs, Ear, Nose, and Throat Section, "Sapienza" University of Rome, Italy.
出版信息
Head Neck. 2015 Jan;37(1):84-91. doi: 10.1002/hed.23563. Epub 2014 Apr 17.
BACKGROUND
Several studies in the last decade evaluated conservative surgical procedures and, in particular, supracricoid operations as an alternative to total laryngectomy for the salvage of recurrences of laryngeal squamous cell carcinoma (SCC) after a first attempt of organ preservation.
METHODS
The clinical records of 68 consecutive patients primarily treated by irradiation or endoscopic surgery and surgically salvaged by total laryngectomy or supracricoid partial laryngectomy in 2 large university hospitals in Italy from 2004 to 2010 were reviewed.
RESULTS
The survival was not affected by the primary treatment or by salvage modality. The only parameter always keeping a prognostic value is the involvement of resection margins of salvage surgery. Patients with early relapse seem to have a worse prognosis than patients with a delayed relapse (p = .05 at Cox multivariate analysis and p = .048 at Wilcoxon test for overall survival [OS] from the primary treatment).
CONCLUSION
Supracricoid operations, if the indications are careful, can prove reliable salvage procedures.
背景
在过去十年中，多项研究评估了保守性手术操作，尤其是环状软骨上手术，作为挽救性手术替代全喉切除术，用于在首次尝试器官保留后复发性喉鳞状细胞癌（SCC）的挽救治疗。
方法
回顾了2004年至2010年期间在意大利两家大型大学医院接受初次放疗或内镜手术治疗，后接受全喉切除术或环状软骨上部分喉切除术进行挽救性手术的68例连续患者的临床记录。
结果
生存情况不受初次治疗或挽救方式的影响。唯一始终具有预后价值的参数是挽救性手术切缘的受累情况。早期复发的患者似乎比延迟复发的患者预后更差（在Cox多因素分析中p = 0.05，在Wilcoxon检验中，从初次治疗开始计算的总生存期[OS] p = 0.048）。
结论
如果适应证选择谨慎，环状软骨上手术可被证明是可靠的挽救性手术。
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