Department of Otolaryngology-Head & Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia.
Head Neck. 2019 Sep;41(9):3133-3143. doi: 10.1002/hed.25807. Epub 2019 May 18.
Outcomes following surgical intervention for laryngeal and hypopharyngeal tumors are dependent on several factors. In the present study, we sought to determine whether tumor subsite, salvage status, and extent of resection influenced postoperative outcomes.
Retrospective review of 107 patients at a single institution who underwent total laryngectomy or partial/total laryngopharyngectomy.
Hypopharyngeal subsite and total laryngopharyngectomy subgroups had inferior speech and swallow outcomes compared to their respective cohorts (P < .05). Salvage patients had inferior 3-year overall survival (P < .05) and swallow outcomes (P < .001). Previously radiated patients had increased fistula rates (29.9% vs 10%, P = .02), and the use of tissue coverage in salvage total laryngectomy had a protective effect on fistula formation (10% vs 37%, P = .04).
By stratifying patients across multiple subgroups, we provide a detailed narrative in surgical outcomes that can be incorporated into treatment planning. Further prospective studies are needed to compare surgical outcomes to those of organ preservation therapy.
喉和下咽肿瘤的手术干预结果取决于多个因素。在本研究中，我们试图确定肿瘤部位、挽救状态和切除范围是否影响术后结果。
对单机构的 107 例患者进行回顾性分析，这些患者接受了全喉切除术或部分/全喉咽切除术。
与相应队列相比，下咽部位和全喉咽切除术亚组的言语和吞咽功能结果较差（P <.05）。挽救组患者的 3 年总生存率（P <.05）和吞咽功能结果（P <.001）均较差。既往放疗患者的瘘管发生率更高（29.9%比 10%，P =.02），挽救性全喉切除术中使用组织覆盖物对瘘管形成有保护作用（10%比 37%，P =.04）。
通过对多个亚组患者进行分层，我们提供了详细的手术结果描述，可用于治疗计划。需要进一步的前瞻性研究来比较手术结果与器官保留治疗的结果。
