Day Andrew T, Sinha Parul, Nussenbaum Brian, Kallogjeri Dorina, Haughey Bruce H
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, U.S.A.
Laryngoscope. 2017 Mar;127(3):597-604. doi: 10.1002/lary.26207. Epub 2016 Aug 31.
OBJECTIVES/HYPOTHESIS: Evaluate the oncologic outcomes of patients with early and select advanced primary glottic squamous cell carcinoma (SCCa) managed by transoral laser microsurgery (TLM).
Retrospective cohort study.
Ninety cases of TLM-managed primary glottic SCCa were identified retrospectively using a prospectively collected database.
Outcomes of patients with pTis-pT2a disease (n = 65) and pT2b-pT4a disease (n = 25) were, respectively: 5-year local control, 86.2% and 67.5%; 5-year disease-free survival, 64.9% and 44.9%; 5-year disease-specific survival, 96.4% and 59.0%; laryngeal preservation, 96.9% and 80%. Five of nine patients (56%) with supraglottic-glottic-subglottic tumors were local recurrence-free compared to the 70 of 81 (86%) patients with glottic, supraglottic-glottic, and glottic-subglottic tumors. Seven of 13 patients (54%) with positive or indeterminate margins were local recurrence-free compared to 68 of 77 (88%) patients with negative margins.
Given sample size considerations, this study highlights the satisfactory oncologic outcomes of TLM-treated glottic cancer and the potential importance of margin management and disease extension within the larynx.
4 Laryngoscope, 127:597-604, 2017.
目的/假设：评估经口激光显微手术（TLM）治疗的早期及部分晚期原发性声门鳞状细胞癌（SCCa）患者的肿瘤学结局。
回顾性队列研究。
使用前瞻性收集的数据库对90例经TLM治疗的原发性声门SCCa病例进行回顾性分析。
pTis-pT2a期疾病患者（n = 65）和pT2b-pT4a期疾病患者（n = 25）的结局分别为：5年局部控制率，86.2%和67.5%；5年无病生存率，64.9%和44.9%；5年疾病特异性生存率，96.4%和59.0%；喉保留率，96.9%和80%。9例声门上-声门-声门下肿瘤患者中有5例（56%）无局部复发，而81例声门、声门上-声门和声门-声门下肿瘤患者中有70例（86%）无局部复发。13例切缘阳性或不确定的患者中有7例（54%）无局部复发，而77例切缘阴性的患者中有68例（88%）无局部复发。
考虑到样本量，本研究突出了TLM治疗声门癌令人满意的肿瘤学结局以及切缘处理和喉内疾病范围的潜在重要性。
4《喉镜》，127:597 - 604，2017年。
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