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喉癌患者挽救性喉切除术的肿瘤学结果。

Oncological results of salvage laryngectomy in patients with laryngeal carcinoma.

作者信息

León Xavier, Montoro Victoria, Rovira Carlota, Neumann Eduard, López Montserrat, García Jacinto, Quer Miquel

机构信息

Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, España.

Servicio de Otorrinolaringología, Hospital de Mollet, Mollet del Vallés, Barcelona, España.

出版信息

Acta Otorrinolaringol Esp (Engl Ed). 2020 Mar-Apr;71(2):70-77. doi: 10.1016/j.otorri.2019.01.001. Epub 2019 Apr 26.

Abstract

OBJECTIVE

To analyse the oncological results of a salvage total laryngectomy in patients with a laryngeal carcinoma.

MATERIAL AND METHODS

Retrospective review of a cohort of 241 patients treated with a salvage laryngectomy after a local recurrence. The initial treatment received by these patients was radiotherapy (n=201, 83.4%), chemoradiotherapy (n=19, 7.9%), and partial surgery (n=21, 8.7%), RESULTS: Total laryngectomy as salvage treatment achieved local control of the disease in 81.3% of cases, with a 5-year specific survival of 65.3%. The variables related with specific survival in a univariate analysis were the location of the primary tumour, the local extension of the initial tumour and of the recurrence, the resection margins, and the pathological status of the neck dissections. According to the results of a multivariate analysis, the variables related to specific survival were the status of the resection margins, the presence of simultaneous regional recurrence, and the local extension of the recurrence.

CONCLUSION

The 5-year specific survival of patients treated with a salvage laryngectomy was 65.3%. The variables related with the control of the disease were the status of the resection margins, the presence of simultaneous regional recurrence and the local extension of the recurrence.

摘要

目的

分析喉癌患者挽救性全喉切除术的肿瘤学结果。

材料与方法

回顾性分析241例局部复发后接受挽救性喉切除术患者的队列。这些患者最初接受的治疗为放疗(n = 201,83.4%)、放化疗(n = 19,7.9%)和部分手术(n = 21,8.7%)。结果:挽救性全喉切除术在81.3%的病例中实现了疾病的局部控制,5年特异性生存率为65.3%。单因素分析中与特异性生存相关的变量有原发肿瘤的部位、初始肿瘤及复发的局部扩展、切缘以及颈部淋巴结清扫的病理状态。根据多因素分析结果,与特异性生存相关的变量有切缘状态、同时存在的区域复发以及复发的局部扩展。

结论

接受挽救性喉切除术患者的5年特异性生存率为65.3%。与疾病控制相关的变量有切缘状态、同时存在的区域复发以及复发的局部扩展。

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