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确定早期声门癌经口激光声带切除术的预后预测因素。

Identifying outcome predictors of transoral laser cordectomy for early glottic cancer.

作者信息

Hoffmann Caroline, Hans Stéphane, Sadoughi Babak, Brasnu Daniel

机构信息

Department of Otolaryngology-Head and Neck Surgery, Hôpital Européen Georges Pompidou, Paris, France.

Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Beth Israel, New York, NY.

出版信息

Head Neck. 2016 Apr;38 Suppl 1:E406-11. doi: 10.1002/hed.24007. Epub 2015 Aug 6.

Abstract

BACKGROUND

The purpose of this study was to determine the predictors of outcomes in patients with early glottic cancer treated by transoral laser cordectomy.

METHODS

This was an inception cohort study of 201 patients with early glottic cancer who were treated by transoral laser cordectomy. Five-year Kaplan-Meier analyses were realized.

RESULTS

Patients with anterior commissure involvement (n = 75) had a significantly lower disease-free survival (DFS) rate (54.6% vs 79.8%; p = .0004), ultimate local control with laser alone rate (71.0% vs 95.7%; p <  .0001), laryngeal preservation rate (91.6% vs 100%; p = .0003), and disease-specific survival (DSS) rate (90.8% vs 99.0%; p = .03). There was no significant difference in overall-survival (OS) rates (76.9% vs 88.5%; p = .29). Surgical margin status was not found to be a significant predictor of outcomes in this series.

CONCLUSION

Although anterior commissure involvement has a significant impact on outcomes, laser cordectomy remains a valuable option considering its high organ preservation and survival rates. In cases of local recurrence, all standard further treatment options remain available. © 2015 Wiley Periodicals, Inc. Head Neck 38: E406-E411, 2015.

摘要

背景

本研究旨在确定经口激光声带切除术治疗早期声门癌患者的预后预测因素。

方法

这是一项对201例接受经口激光声带切除术的早期声门癌患者的起始队列研究。进行了五年的Kaplan-Meier分析。

结果

前联合受累患者(n = 75)的无病生存率(DFS)显著较低(54.6%对79.8%;p = .0004),单纯激光最终局部控制率(71.0%对95.7%;p < .0001),喉保留率(91.6%对100%;p = .0003),以及疾病特异性生存率(DSS)(90.8%对99.0%;p = .03)。总生存率(OS)无显著差异(76.9%对88.5%;p = .29)。在本系列中,手术切缘状态未被发现是预后的显著预测因素。

结论

尽管前联合受累对预后有显著影响,但考虑到其高器官保留率和生存率,激光声带切除术仍然是一个有价值的选择。在局部复发的情况下,所有标准的进一步治疗选择仍然可用。© 2015威利期刊公司。头颈外科38:E406-E411,2015。

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