Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg Medical School, Erlangen, Germany.
J Otolaryngol Head Neck Surg. 2014 Jan 28;43(1):4. doi: 10.1186/1916-0216-43-4.
Management of advanced laryngeal cancer is complex and ideal strategy is yet to be defined. This study evaluates the experience of a single head and neck oncologic centre in the management of T4 laryngeal cancer.
Retrospective assessment of cases primarily treated for T4a squamous cell carcinoma of the larynx, between 1980 and 2007, at a tertiary referral center.
A total of 384 cases were studied. Five-year disease specific survival was 56.2% and local control 87.4%. Regional and distal control estimates were 90.3% and 88.3% respectively. Prognosis was significantly superior for cases treated with primary surgery compared to cases solely managed with non-surgical modalities. Positive surgical margins and regional disease worsened prognosis.
This study suggests that primary surgery remains a key element in the treatment of advanced laryngeal cancer. The need for well-designed, prospective, randomised studies in order to further evaluate the remaining role of primary surgery in the modern management of locally advanced laryngeal lesions is emphasized.
晚期喉癌的治疗较为复杂，理想的治疗策略仍有待确定。本研究评估了一家头颈肿瘤中心在治疗 T4 期喉癌方面的经验。
对 1980 年至 2007 年期间在一家三级转诊中心接受治疗的 T4a 期喉鳞状细胞癌患者进行回顾性评估。
共研究了 384 例患者。5 年疾病特异性生存率为 56.2%，局部控制率为 87.4%。区域和远处控制估计值分别为 90.3%和 88.3%。与仅采用非手术治疗的患者相比，接受初始手术治疗的患者预后明显更好。阳性手术切缘和区域疾病恶化了预后。
本研究表明，初始手术仍然是治疗晚期喉癌的关键因素。强调需要进行精心设计、前瞻性、随机研究，以进一步评估初始手术在局部晚期喉病变现代治疗中的剩余作用。
Zotero 插件