T4期下咽喉癌的原发性全喉切除术和下咽喉切除术：肿瘤学及功能结果和预后因素

Primary total laryngectomy and pharyngolaryngectomy in T4 pharyngolaryngeal cancers: Oncologic and functional results and prognostic factors.

作者信息

Roux M, Dassonville O, Ettaiche M, Chamorey E, Poissonnet G, Bozec A

机构信息

Institut universitaire de la face et du cou, 31, avenue de Valombrose, 06103 Nice, France.

Département de biostatistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France.

出版信息

Eur Ann Otorhinolaryngol Head Neck Dis. 2017 May;134(3):151-154. doi: 10.1016/j.anorl.2016.11.009. Epub 2016 Dec 14.

DOI:10.1016/j.anorl.2016.11.009

PMID:27988198

Abstract

OBJECTIVES

The aims of this study were to assess oncologic and functional outcome in primary total laryngectomy or pharyngolaryngectomy (TL/TL/TPL) for laryngeal or hypopharyngeal cancer with extra-laryngeal extension (T4) and to determine the predictive factors of these results.

MATERIAL AND METHODS

A retrospective analysis was performed on the computerized medical records of all patients undergoing primary TL/TPL for T4 larynx or hypopharynx squamous cell carcinoma between 2000 and 2014 at our institution. Predictive factors of oncologic and functional outcome were investigated on univariate and multivariate analysis.

RESULTS

Sixty-three patients (58 men, 5 women; mean age, 68.8±9.7 years) were included. Overall and disease-specific survivals were 69% and 80% at 3 years, and 56% and 69% at 5 years, respectively. On multivariate analysis, gender (female, P<0.001), ASA score (ASA≥3; P=0.006) and vascular embolism (P=0.006) had significant pejorative impact on overall survival. Six months after end of treatment, 90% of patients had recovered independent oral feeding and 83% of those with tracheoesophageal voice prostheses had recovered an intelligible voice.

CONCLUSION

Primary TL/TPL remains the gold standard treatment for T4 larynx or hypopharynx cancer. It provides satisfactory oncologic and functional outcomes.

摘要

目的

本研究旨在评估全喉切除术或喉咽切除术（TL/TL/TPL）治疗伴有喉外侵犯（T4）的喉癌或下咽癌的肿瘤学及功能学结局，并确定这些结果的预测因素。

材料与方法

对2000年至2014年在本机构接受T4期喉或下咽鳞状细胞癌初次TL/TPL手术的所有患者的电子病历进行回顾性分析。通过单因素和多因素分析研究肿瘤学及功能学结局的预测因素。

结果

纳入63例患者（58例男性，5例女性；平均年龄68.8±9.7岁）。3年总生存率和疾病特异性生存率分别为69%和80%，5年分别为56%和69%。多因素分析显示，性别（女性，P<0.001）、美国麻醉医师协会（ASA）评分（ASA≥3；P=0.006）和血管栓塞（P=0.006）对总生存有显著不良影响。治疗结束6个月后，90%的患者恢复了独立经口进食，83%植入气管食管发音假体的患者恢复了可理解的语音。