Gorphe P, Blanchard P, Breuskin I, Temam S, Tao Y, Janot F
Department of Head and Neck Oncology,Institut Gustave Roussy,Villejuif,France.
Department of Radiotherapy,Institut Gustave Roussy,Villejuif,France.
J Laryngol Otol. 2015 Sep;129(9):903-9. doi: 10.1017/S002221511500184X. Epub 2015 Jul 23.
This study aimed to assess the influence of supra- and subglottic extensions and vocal fold mobility on outcome in a large monocentric cohort of 148 patients treated for tumour-node-metastasis stage T2N0 glottic carcinomas.
In all, 107 glottic carcinoma patients had normal vocal fold mobility (T2aN0), and 41 had impaired vocal fold mobility (T2bN0). Treatment decisions were made by a multidisciplinary team.
Vocal fold mobility was associated with overall survival, disease-free survival, local control, larynx preservation and laryngectomy-free survival. For patients with T2a lesions, local control, laryngectomy-free survival and disease-free survival improved after surgery but overall survival did not. For patients with T2b lesions, local control, laryngectomy-free survival, disease-free survival and overall survival were all higher after surgery than after radiotherapy.
This study highlights for the first time the importance of vocal fold mobility in treatment outcomes and is the first to assess its influence on survival. Updated tumour-node-metastasis classifications should consider the distinction between T2a and T2b lesions.
本研究旨在评估声门上及声门下扩展以及声带活动度对148例接受肿瘤-淋巴结-转移分期为T2N0声门癌治疗的大型单中心队列患者预后的影响。
总共107例声门癌患者声带活动度正常（T2aN0），41例患者声带活动度受损（T2bN0）。治疗决策由多学科团队做出。
声带活动度与总生存期、无病生存期、局部控制率、喉保留率及无喉切除术生存期相关。对于T2a期病变患者，术后局部控制率、无喉切除术生存期及无病生存期有所改善，但总生存期未改善。对于T2b期病变患者，术后局部控制率、无喉切除术生存期、无病生存期及总生存期均高于放疗后。
本研究首次强调了声带活动度对治疗结局的重要性，并且首次评估了其对生存的影响。更新的肿瘤-淋巴结-转移分类应考虑T2a和T2b病变之间的区别。
