Echanique Kristen A, Desai Stuti V, Marchiano Emily, Spinazzi Eleonora F, Strojan Primož, Baredes Soly, Eloy Jean Anderson
1 Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
2 Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
Otolaryngol Head Neck Surg. 2017 Jan;156(1):38-45. doi: 10.1177/0194599816662631. Epub 2016 Aug 9.
Objective Laryngeal verrucous carcinoma (LVC) is a rare, locally invasive neoplasm comprising 1% to 3.4% of laryngeal carcinomas. Management strategies are a topic of ongoing conversation, and no definitive treatment protocol based on T stage and presentation exists. This review examines characteristics, treatment modalities, and patient outcomes of LVC. Data Sources PubMed, MEDLINE, EMBASE, and Web of Science. Methods Databases were searched through October 29, 2015, for literature detailing individual patient cases of LVC. Variables analyzed included patient demographics, tumor characteristics, tumor size, treatment, and outcomes. Results Thirty-seven articles with 369 cases were included. LVC was found more commonly in males (13.8:1), at an average age of 58.7 years, and located in the glottis (74.0%). Most patients had local disease at presentation (94.9%). The most common presenting symptom was hoarseness (92.3%). The most common primary treatment was surgery alone (72.3%), with local excision as the most common technique (56.8%). In patients with data available on both surgical modality and T stage, most patients who presented as T1 and were managed surgically underwent local excision (79.2%). Surgical treatment alone led to high rates of disease-free survival at follow-up (86.8%). A large number of patients presenting with T1 disease were disease free at follow-up (88.6%). Overall survival was 80.3%. Conclusion LVC is most often managed surgically. The extent of surgical resection may be guided by T stage, with smaller tumors resected via local excision and larger tumors via partial or total laryngectomy. Regardless of T stage or therapy, LVC has a good posttreatment prognosis.
目的 喉疣状癌(LVC)是一种罕见的局部浸润性肿瘤,占喉癌的1%至3.4%。治疗策略是一个持续讨论的话题,目前尚无基于T分期和临床表现的确切治疗方案。本综述探讨了LVC的特征、治疗方式和患者预后。 数据来源 PubMed、MEDLINE、EMBASE和科学网。 方法 检索数据库至2015年10月29日,查找详细描述LVC个体病例的文献。分析的变量包括患者人口统计学、肿瘤特征、肿瘤大小、治疗和预后。 结果 纳入37篇文章,共369例病例。LVC在男性中更为常见(13.8:1),平均年龄58.7岁,位于声门(74.0%)。大多数患者就诊时为局部病变(94.9%)。最常见的症状是声音嘶哑(92.3%)。最常见的主要治疗方法是单纯手术(72.3%),其中局部切除是最常见的技术(56.8%)。在有手术方式和T分期数据的患者中,大多数表现为T1且接受手术治疗的患者接受了局部切除(79.2%)。单纯手术治疗在随访中导致较高的无病生存率(86.8%)。大量表现为T1期疾病的患者在随访中无病(88.6%)。总生存率为80.3%。 结论 LVC最常采用手术治疗。手术切除范围可根据T分期指导,较小的肿瘤通过局部切除,较大的肿瘤通过部分或全喉切除。无论T分期或治疗方法如何,LVC的治疗后预后良好。