早期声门型喉癌手术挽救后复发的初始治疗的预后影响。
Prognostic impact of initial treatment in surgically salvaged recurrences of early glottic cancer.
机构信息
Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy.
Department of Surgery and Translational Medicine, University of Florence, all in, Florence, Italy.
出版信息
Laryngoscope. 2019 Oct;129(10):2328-2333. doi: 10.1002/lary.27702. Epub 2018 Dec 18.
OBJECTIVE
The purpose of this study was to analyze the outcomes of surgically salvaged early glottic cancer (EGC) recurrences after initial radiotherapy (RT) or transoral laser microsurgery (TLM).
METHODS
A matched pair analysis by recurrent tumor-node-metastasis stage (rTNM) considering 27 patients who had TLM as initial treatment and 54 patients who failed after primary RT was performed. Post-recurrence overall and disease-specific survival (DSS) were evaluated.
RESULTS
The RT-failed group showed worse post-recurrence overall survival (P < .001) and DSS (P = .005) compared to TLM-first group despite the same rTNM stage. The RT failed patients also showed more postoperative complications (longer mean decannulation time, P = .005; nasogastric feeding tube dependence, P = .012) and a higher rate of second locoregional recurrences (P = .004).
CONCLUSION
The RT-failed EGC showed worse outcomes in terms of survival, complications, and locoregional recurrences compared to same recurrent TNM stage TLM-failed cases.
LEVEL OF EVIDENCE
3 Laryngoscope, 129:2328-2333, 2019.
目的
本研究旨在分析初始放疗（RT）或经口激光显微手术（TLM）后手术挽救的早期声门癌（EGC）复发的结果。
方法
通过考虑初始治疗为 TLM 的 27 例患者和初次 RT 失败的 54 例患者的复发性肿瘤-淋巴结-转移分期（rTNM）进行配对分析。评估了复发后的总生存率和疾病特异性生存率（DSS）。
结果
尽管 rTNM 分期相同，但与 TLM 组相比，RT 失败组的复发后总生存率（P <.001）和 DSS（P =.005）更差。RT 失败的患者还表现出更多的术后并发症（更长的平均拔管时间，P =.005；需要鼻饲管，P =.012）和更高的二次局部区域复发率（P =.004）。
结论
与相同复发性 TNM 分期的 TLM 失败病例相比，RT 失败的 EGC 在生存率、并发症和局部区域复发方面的结果更差。
证据水平
3 级喉镜，129:2328-2333，2019。
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