Weiss Bernhard G, Ihler Friedrich, Pilavakis Yiannis, Wolff Hendrik A, Canis Martin, Welz Christian, Steiner Wolfgang
Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Germany.
University of Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Germany.
Eur Arch Otorhinolaryngol. 2017 Apr;274(4):1997-2004. doi: 10.1007/s00405-016-4432-4. Epub 2016 Dec 27.
For the treatment of T1b glottic carcinoma, different treatment options, such as transoral laser microsurgery, open surgical techniques, and primary radiotherapy, are under discussion. In this context, the aim of the present study was to describe oncologic results and complication rates of transoral laser microsurgery in treatment of T1b glottic carcinoma. This is a retrospective unicenter chart review of patients treated at an academic tertiary referral center between 1986 and 2006. Fifty-one previously untreated T1b cases were exclusively treated by transoral laser microsurgery and included into this study, 47 were male, and 4 were female. The main outcome measures included local control rate and complications, overall, disease specific, and recurrence-free survival. The median follow-up period was 98 months. The 5-year local control rate was 90.2%; larynx preservation rate was 92.2%. No intra- or postoperative complications, such as wound infections, postoperative bleeding, hematoma, edema, and fistula development, were observed. A single patient required revision surgery due to synechia. Five-year survival rates were: overall 84.7%, disease specific 97.7%, and recurrence free 72.4%. Our data support the conclusion that transoral laser microsurgery is a considerable treatment option in T1b glottic carcinoma. The oncologic outcome was at least comparable to other treatment options, while the perioperative morbidity and complication rate were lower.
对于T1b期声门癌的治疗，诸如经口激光显微手术、开放手术技术和原发性放疗等不同的治疗方案正在讨论中。在此背景下，本研究的目的是描述经口激光显微手术治疗T1b期声门癌的肿瘤学结果和并发症发生率。这是一项对1986年至2006年间在一家学术性三级转诊中心接受治疗的患者进行的回顾性单中心病历审查。51例未经治疗的T1b期病例仅接受经口激光显微手术治疗并纳入本研究，其中47例为男性，4例为女性。主要观察指标包括局部控制率和并发症、总体生存率、疾病特异性生存率和无复发生存率。中位随访期为98个月。5年局部控制率为90.2%；喉保留率为92.2%。未观察到术中和术后并发症，如伤口感染、术后出血、血肿、水肿和瘘管形成。1例患者因粘连需要再次手术。5年生存率分别为：总体84.7%，疾病特异性97.7%，无复发72.4%。我们的数据支持以下结论：经口激光显微手术是T1b期声门癌一种相当不错的治疗选择。其肿瘤学结果至少与其他治疗选择相当，而围手术期发病率和并发症发生率较低。
