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环状软骨上部分喉切除术联合环状软骨舌骨会厌固定术治疗声门癌的长期临床疗效

Long-term clinical outcomes of supracricoid partial laryngectomy with cricohyoidoepiglottopexy for glottic carcinoma.

作者信息

Gong Hongli, Zhou Liang, Wu Haitao, Tao Lei, Chen Xiaoling, Li Xiaoming, Li Cai, Zhou Jian

机构信息

a Shanghai Key Clinical Disciplines of Otorhinolaryngology, Department of Otorhinolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University , Shanghai , China.

出版信息

Acta Otolaryngol. 2019 Sep;139(9):803-809. doi: 10.1080/00016489.2019.1616820. Epub 2019 Jun 26.

Abstract

Laryngeal carcinoma should be treated with the intent of organ-sparing, and supracricoid partial laryngectomy with cricohyoidoepiglottopexy (CHEP) might be an important option. The purpose of this study was to evaluate the clinical outcomes of glottic carcinoma patients treated with CHEP. A series of 164 cases with glottic carcinoma undergoing CHEP from 2006 to 2010 was retrospectively analyzed. The 10-year overall survival (OS) rate, disease-specific survival (DSS) rate, and disease-free survival (DFS) rate were 77.6%, 78.8%, 74.1%, respectively. The OS, DSS, and DFS of patients with stage T1 were higher than patients with stages T2 and T3. Patients with locoregional recurrence and distant metastases had lower OS and DFS than patients with neither recurrence nor metastasis. The DFS of patients with advanced laryngeal carcinoma was worse than that of patients with early-stage carcinoma. T2 and T3 stages, locoregional recurrence, and distant metastases had predictive value regarding patient survival. Additionally, the decannulation rate of postoperative patients was 95.1%, and the nasogastric feeding tube removal rate was 100%. CHEP provided reliable oncologic and functional outcomes, and it should be considered as a standard function-sparing option for glottic T1b, T2, and selected T3 carcinoma patients.

摘要

喉癌的治疗应以保留器官为目的,环状软骨上部分喉切除术联合环舌会厌固定术(CHEP)可能是一个重要的选择。本研究的目的是评估接受CHEP治疗的声门癌患者的临床疗效。回顾性分析了2006年至2010年期间接受CHEP治疗的164例声门癌患者。10年总生存率(OS)、疾病特异性生存率(DSS)和无病生存率(DFS)分别为77.6%、78.8%、74.1%。T1期患者的OS、DSS和DFS高于T2期和T3期患者。发生局部区域复发和远处转移的患者的OS和DFS低于既无复发也无转移的患者。晚期喉癌患者的DFS比早期癌患者差。T2和T3期、局部区域复发和远处转移对患者生存具有预测价值。此外,术后患者的拔管率为95.1%,鼻饲管拔除率为100%。CHEP提供了可靠的肿瘤学和功能学结果,对于声门T1b、T2和部分T3期癌患者,应将其视为一种标准的保留功能的选择。

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