Leone C A, Capasso P, Russo G, D'Errico P, Cutillo P, Orabona P
Otolaryngology Head and Neck Surgery Unit of "Azienda Ospedaliera di Rilievo Nazionale dei Colli - Ospedale Monaldi", Naples, Italy.
Acta Otorhinolaryngol Ital. 2014 Oct;34(5):317-26.
The purpose of this study was to evaluate the oncological and functional outcomes in patients who underwent supracricoid laryngectomies with a crico-hyoidopexy (SCL-CHP) or a crico-hyoido-epiglottopexy (SCL-CHEP) for the treatment of primary and reccurent laryngeal cancer. A retrospective study was conducted on 152 consecutive patients seen from January 1996 to December 2006. Overall survival (OS) and disease-free survival (DFS) were analysed using the Kaplan-Meier method, and were compared according to the type of surgery and clinical stage of the tumour. The mean period before decannulation, nasogastric tube (NGT) removal and recovery of a normal diet and speech were evaluated, and statistical analyses were performed regarding the association with the type of surgery and arytenoidectomy. The median follow-up period was 49.9 months (range: 10-110 months). The 3- and 5-year OS were 87.5 and 83.5%, respectively, and 3- and 5-year DFS were 78.3 and 73.7%, respectively. For patients with early stages tumours, the 5-year OS and DFS were 92.3 and 84.6% respectively, whereas for patients with locally advanced stage tumours, the OS and DFS were 74.3 and 62.2%, respectively. Significant differences in OS and DFS for patients who had early or locally advanced cancers were found (p = 0.0004 and p = 0.0032, respectively). The rate of overall local control was 92.1%, while the mean period until decannulation or NGT removal was 25.1 and 16.6 days, respectively. The mean period until NGT removal was significantly different according to the type of surgery (p = 0.0001) and whether arytenoidectomy was performed (p = 0.0001). The reliable oncological and functional results of SCL for early and locally advanced laryngeal cancers are confirmed by our series of patients.
本研究旨在评估接受环状软骨上喉切除术联合环舌骨固定术（SCL-CHP）或环舌会厌固定术（SCL-CHEP）治疗原发性和复发性喉癌患者的肿瘤学及功能预后。对1996年1月至2006年12月期间连续收治的152例患者进行了回顾性研究。采用Kaplan-Meier法分析总生存（OS）和无病生存（DFS）情况，并根据手术类型和肿瘤临床分期进行比较。评估了拔管前、鼻胃管（NGT）拔除以及恢复正常饮食和言语的平均时间，并就其与手术类型及杓状软骨切除术的相关性进行了统计分析。中位随访期为49.9个月（范围：10 - 110个月）。3年和5年总生存率分别为87.5%和83.5%，3年和5年无病生存率分别为78.3%和73.7%。对于早期肿瘤患者，5年总生存率和无病生存率分别为92.3%和84.6%，而对于局部晚期肿瘤患者，总生存率和无病生存率分别为74.3%和62.2%。早期或局部晚期癌症患者的总生存和无病生存存在显著差异（分别为p = 0.0004和p = 0.0032）。总体局部控制率为92.1%，而拔管或拔除鼻胃管的平均时间分别为25.1天和16.6天。拔除鼻胃管的平均时间根据手术类型（p = 0.0001）和是否进行杓状软骨切除术（p = 0.0001）存在显著差异。我们的系列患者证实了SCL对早期和局部晚期喉癌具有可靠的肿瘤学及功能结果。
