Tao L, Zhou L, Wu H T, Gong H L, Chen X L, Li X M, Li C, Zhou J
Shanghai Key Clinical Disciplines of Otorhinolaryngology, Department of Otorhinolaryngology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai 200031, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Feb 7;53(2):97-104. doi: 10.3760/cma.j.issn.1673-0860.2018.02.004.
To evaluate the oncologic and functional outcomes of supracricoid partial laryngectomy (SCPL) in the treatment of laryngeal carcinoma. A total of 298 laryngeal carcinoma patients who underwent SCPL treatment from January 2005 to December 2013 were reviewed retrospectively. Clinical data of demographic and clinical characteristics, postoperative complications, rehabilitation information, recurrence and metastasis were analysed. Survival and local control were used to evaluate the clinical outcome.Data were analyzed by SPSS 23.0 software. Thirty-one patients with supraglottic carcinoma underwent cricohyoidoepiglottopexy (CHEP)and 267 with glottic carcinoma underwent cricohyoidopexy (CHP) were enrolled in this study. The mean duration of followed up was 74 months, ranging from 12 to 146 months. Fifty-four cases died at last follow-up. With respect to 31 patients with supraglottic carcinoma, 5- and 10-year overall survival rates and disease specific survival rates all were 78.1%; 5- and 10-year disease free survival rates were 72.1% and 63.7% respectively; and 5- and 10-year local control rates were both 84.2%. In 267 patients with glottic carcinoma, 5- and 10-year overall survival rates were 85.8% and 77.1% respectively; 5- and 10-year disease specific survival rates were 86.6% and 78.4% respectively; 5- and 10-year disease free survival rates were 80.6% and 74.2% respectively; and 5- and 10-year local control rates were 90.0% and 89.4% respectively. The survival rate of patients with glottic carcinoma at stage T1 was higher than that at stage T2 or T3, and the disease free survival rate of patients with early stage was superior than that of patients with advance stage. Cox regression analysis showed that tumor stage T2, and T3, tumor recurrence, and tumor metastasis were independent risk factors for survival. Furthermore, nasogastric feeding tube removal rate was 100% and the decannulation rates of SCPL were 96% in the patients with SCPL. SCPL is a safe procedure with tumor resection for laryngeal carcinoma, with preserving of swallowing, respiration, and phonation functions, and has excellent survival and local control rates. This procedure could be considered as a standard function-sparing treatment for selected patients with laryngeal carcinoma of stages T1b-T3.
评估环状软骨上部分喉切除术（SCPL）治疗喉癌的肿瘤学及功能预后。回顾性分析2005年1月至2013年12月期间接受SCPL治疗的298例喉癌患者的临床资料，分析患者的人口统计学和临床特征、术后并发症、康复情况、复发及转移情况，采用生存率和局部控制率评估临床疗效，数据采用SPSS 23.0软件进行分析。本研究纳入31例行环舌会厌固定术（CHEP）的声门上癌患者和267例行环甲固定术（CHP）的声门癌患者，平均随访时间为74个月，范围为12至146个月。末次随访时54例患者死亡。对于31例声门上癌患者，5年和10年总生存率及疾病特异性生存率均为78.1%；5年和10年无病生存率分别为72.1%和63.7%；5年和10年局部控制率均为84.2%。对于267例声门癌患者，5年和10年总生存率分别为85.8%和77.1%；5年和10年疾病特异性生存率分别为86.6%和78.4%；5年和10年无病生存率分别为80.6%和74.2%；5年和10年局部控制率分别为90.0%和89.4%。T1期声门癌患者的生存率高于T2期或T3期患者，早期患者的无病生存率优于晚期患者。Cox回归分析显示，肿瘤分期T2、T3、肿瘤复发及肿瘤转移是生存的独立危险因素。此外，SCPL患者鼻饲管拔除率为100%，拔管率为96%。SCPL是一种安全的喉癌肿瘤切除手术，可保留吞咽、呼吸及发声功能，具有良好的生存率和局部控制率，该手术可作为T1b - T3期部分喉癌患者的标准功能保留治疗方法。
