Nair Sudhir Vasudevan, Mair Manish, Sawarkar Noopur, Chakrabarti Swagnik, Qayyumi Burhanuddin, Nair Deepa, Chaturvedi Pankaj, Gupta Tejpal, Agrawal Jai Prakash
Head and Neck Surgical Oncology, Homi Bhabha National Institute, Tata Memorial Center, Room No. 1206, Homi Bhabha Block, Dr. E. Borges Road, Parel, Mumbai, 400012, India.
Radiation Oncology, Homi Bhabha National Institute, Tata Memorial Center, Mumbai, India.
Eur Arch Otorhinolaryngol. 2018 Sep;275(9):2311-2316. doi: 10.1007/s00405-018-5047-8. Epub 2018 Jun 29.
The main objective is to compare the oncologic outcomes of patients with T3 laryngeal cancers who underwent total laryngectomy or organ preservation protocol (OPP) as the initial plan of management.
This is a retrospective study on 120 patients treated for T3 laryngeal and hypopharyngeal cancers. Patients with functional larynx underwent OPP and dysfunctional larynx underwent upfront laryngectomy. Median follow-up of the patients was 4.6 years.
There was a significant difference in 3 year disease-free survival (DFS) between upfront laryngectomy and OPP (73.2 vs. 55.7%; P = 0.028) group but not in 3 year overall survival (73.2 vs. 68.7%, P = 0.8). The rate laryngeal preservation was 65% in CCRT and 44% in only radiotherapy group. At 3 years, the laryngectomy-free survival was 57.2% and the laryngo-esophageal dysfunction-free survival (LEDS) was 53.0%.
T3 laryngeal cancers treated with upfront laryngectomy have an improved DFS when compared to those treated with non-surgical modalities. Primary surgery should be offered as an option for selected patients especially when CCRT is not feasible.
主要目的是比较接受全喉切除术或器官保留方案（OPP）作为初始治疗方案的T3期喉癌患者的肿瘤学结局。
这是一项对120例接受T3期喉癌和下咽癌治疗的患者的回顾性研究。喉功能正常的患者接受OPP，喉功能障碍的患者接受一期喉切除术。患者的中位随访时间为4.6年。
一期喉切除术组和OPP组的3年无病生存率（DFS）存在显著差异（73.2%对55.7%；P = 0.028），但3年总生存率无显著差异（73.2%对68.7%，P = 0.8）。同步放化疗组的喉保留率为65%，单纯放疗组为44%。3年时，无喉切除术生存率为57.2%，无喉食管功能障碍生存率（LEDS）为53.0%。
与接受非手术治疗的患者相比，接受一期喉切除术治疗的T3期喉癌患者的DFS有所改善。对于选定的患者，尤其是在同步放化疗不可行时，应将一期手术作为一种选择。
