Yang S Z, Zhou C Y, Wang F, Sun B C, Han Z L, Shen Y, Han J H, Zhang H J
Department of Otorhinolaryngology, First Affiliated Hospital to the People Liberation Army General Hospital, Beijing 100048, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Feb 7;53(2):86-91. doi: 10.3760/cma.j.issn.1673-0860.2018.02.002.
To explore the key technique and outcome of transoral radiofrequency ablation microsurgery for early stage of glottic carcinoma with anterior commissure involvement (ACI). A retrospective analysis was conducted on 31 patients, who were diagnosed as early stage glottic carcinoma during January 2010 to March 2016 in ENT Department. According to whether the anterior commissure was involved or not, two groups were divided. There were eleven cases with ACI (stages T1a, T1b, and T2). Twenty cases without ACI (stages Tis, T1a, and T2). All the patients received transoral radiofrequency ablation microsurgery and followed up closely.Only one case received radiotheraphy after surgery. SPSS19.0 software was used to analyze data. The follow-up time was 12-67 months, and the median follow-up time was 30 months. Nine among 11 cases with ACI obtained good oncologic outcomes, initial local recurrence was identified in 2/11 cases, including 2 cases of T2. Two cases ultimately required salvage total laryngectomy. Meanwhile, initial local recurrence was identified in 2/20 cases without ACI, including 1 case of T1a and 1 case of T2. One case underwent elective neck dissection, and another one received salvage total laryngectomy.Compared to the patients without ACI, it seemed that the cases with ACI always accomponied with a little higher initial local recurrence and lower overall laryngealpreservation, but the difference had no significance (>0.05). Transoral radiofrequency ablation microsurgery is an effective treatment for glottic carcinoma with ACI. Its advantages, such as more flexibility and deformability, make it more feasible to operate at the narrow space of anterior commissure assisted with laryngeal endoscopy.Good oncologic outcomes can be obtained by this technique with lower initial local recurrence as well as higher overall laryngeal preservation rate.
探讨经口射频消融显微手术治疗累及前联合的早期声门型喉癌的关键技术及疗效。对2010年1月至2016年3月在耳鼻喉科确诊为早期声门型喉癌的31例患者进行回顾性分析。根据前联合是否受累分为两组。累及前联合的有11例(T1a、T1b和T2期)。未累及前联合的有20例(Tis、T1a和T2期)。所有患者均接受经口射频消融显微手术并密切随访。仅1例患者术后接受了放疗。采用SPSS19.0软件进行数据分析。随访时间为12 - 67个月,中位随访时间为30个月。11例累及前联合的患者中9例获得了良好的肿瘤学结局,2/11例出现初始局部复发,包括2例T2期患者。2例最终需要挽救性全喉切除术。同时,20例未累及前联合的患者中有2例出现初始局部复发,包括1例T1a期和1例T2期患者。1例行择期颈部清扫术,另1例接受挽救性全喉切除术。与未累及前联合的患者相比,累及前联合的患者初始局部复发率似乎略高,总体喉保留率略低,但差异无统计学意义(>0.05)。经口射频消融显微手术是治疗累及前联合的声门型喉癌的有效方法。其具有的灵活性和可变形性等优点,使其在喉镜辅助下在前联合狭窄空间操作更可行。该技术可获得良好的肿瘤学结局,初始局部复发率较低,总体喉保留率较高。