Hay Ashley, Simo Ricard, Hall Gillian, Tharavai Selvam, Oakley Richard, Fry Alastair, Cascarini Luke, Lei Mary, Guerro-Urbano Teresa, Jeannon Jean-Pierre
Head and Neck Surgery Department, Guys and St Thomas' NHS Trust, Great Maze Pond, London, SE1 9RT, UK.
Eur Arch Otorhinolaryngol. 2019 Apr;276(4):1153-1159. doi: 10.1007/s00405-019-05295-x. Epub 2019 Jan 21.
The purpose of this study was to review our recent experience of salvage surgery, comparing larynx and oropharynx recurrence patterns.
A single centre, retrospective review of salvage surgery for recurrent head and neck cancer including patients between 2008 and 2016.
61 patients were identified, 36 underwent salvage laryngectomy and 25 received oropharyngeal resections. The median overall survival of oropharyngeal recurrent tumors was 26 months (95% CI 15-118 months) and for laryngeal tumors was 23 months (95% CI 11-38 months), p = 0.1008. There was a significant overall survival benefit in patients with negative resection margin. The median survival in the negative margin group was 38 months (95% CI 25-108 months) compared to the positive margin group, 9 months (95% CI 5-15 months), p < 0.0001.
Survival results following surgical salvage in the larynx and oropharynx appear to be similarly poor. Those patients with clear margins appear to have a significantly better prognosis.
本研究的目的是回顾我们近期的挽救性手术经验，比较喉和口咽复发模式。
对2008年至2016年间接受复发性头颈癌挽救性手术的患者进行单中心回顾性研究。
共纳入61例患者，36例行挽救性喉切除术，25例行口咽切除术。口咽复发性肿瘤的中位总生存期为26个月（95%可信区间15 - 118个月），喉肿瘤为23个月（95%可信区间11 - 38个月），p = 0.1008。手术切缘阴性的患者有显著的总生存获益。切缘阴性组的中位生存期为38个月（95%可信区间25 - 108个月），而切缘阳性组为9个月（95%可信区间5 - 15个月），p < 0.0001。
喉和口咽挽救性手术后的生存结果似乎同样较差。切缘清晰的患者预后明显更好。
