T3 声门型喉鳞状细胞癌外科治疗的肿瘤学结果。
Oncologic outcomes of surgical treatment for T3 glottic laryngeal squamous cell carcinoma.
机构信息
Department of Otorhinolaryngology, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China.
出版信息
Head Neck. 2018 Aug;40(8):1734-1742. doi: 10.1002/hed.25144. Epub 2018 Mar 30.
BACKGROUND
The purpose of this study was to assess the clinical results of patients with T3 glottic laryngeal carcinoma treated with total laryngectomy or partial laryngectomy.
METHODS
We conducted a retrospectively review of 307 patients with T3 glottic laryngeal squamous cell carcinoma (SCC).
RESULTS
The 5-year cancer-specific survival (CSS) rate was 71.5% and the overall survival (OS) rate was 70.6%. For patients who underwent total laryngectomy, the 5-year disease-free survival (DFS) rate was 59.8%, and the CSS rate was 67.9%. For partial laryngectomy, the 5-year DFS rate was 64.8%, and the CSS rate was 78.0%. High lymph node and stage status are predictors of mortality for these patients. No difference was found in DFS and CSS rates between patients with negative margins and those with positive margins after postoperative radiotherapy and chemotherapy.
CONCLUSION
Postoperative radiotherapy and chemotherapy are effective treatments for patients with T3 glottic laryngeal carcinoma, especially with a positive margin. For selected patients with T3 glottic laryngeal carcinoma, partial laryngectomy is a good choice because it can achieve satisfactory oncologic results while preserving laryngeal function.
背景
本研究旨在评估行全喉切除术或喉部分切除术治疗 T3 声门型喉癌患者的临床结果。
方法
我们回顾性分析了 307 例 T3 声门型喉鳞状细胞癌（SCC）患者。
结果
5 年癌症特异性生存率（CSS）为 71.5%，总生存率（OS）为 70.6%。行全喉切除术的患者，5 年无病生存率（DFS）为 59.8%，CSS 为 67.9%。行喉部分切除术的患者，5 年 DFS 为 64.8%，CSS 为 78.0%。高淋巴结状态和分期是这些患者死亡的预测因素。术后放化疗后，边缘阴性和阳性患者的 DFS 和 CSS 率无差异。
结论
术后放化疗是 T3 声门型喉癌患者的有效治疗方法，尤其是边缘阳性患者。对于选择的 T3 声门型喉癌患者，喉部分切除术是一种较好的选择，因为它可以在保留喉功能的同时获得满意的肿瘤学结果。
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