经口激光显微手术治疗Tis、T1 和 T2 声门型喉癌：5 年随访结果。
Transoral laser microsurgery for Tis, T1, and T2 glottic carcinoma: 5-year follow-up.
机构信息
Department of Surgery, Unit of Otolaryngology, University of Cagliari, Cagliari, Italy.
Department of Sense Organs, Sapienza University of Rome, Viale dell'Università, 33, 00186, Rome, Italy.
出版信息
Lasers Med Sci. 2021 Apr;36(3):507-512. doi: 10.1007/s10103-020-03049-4. Epub 2020 May 29.
The aim of this retrospective study is to evaluate the results obtained with CO TOLMS in patients with Tis, T1, and T2 glottic tumors at our Department from 2004 to 2016 treated with CO TOLMS. One hundred eighty-five patients having a median age of 67 years (range 42-88) were included in the present analysis. The tumor stages of the patients included 134 pTis-T1a, 12 pT1b, and 39 pT2 cases. Median duration of follow-up for the whole study cohort was 55 months (range 24-108 months). At 5-year follow-up, local control was 91%, 83%, and 79.4% for T1a, T1b, and T2 respectively. Disease-specific survival was 95.5%, 91.6%, and 92.3%. Overall survival was 73.8%, 91.6%, and 82%, and larynx preservation was 96.2%, 83%, and 84.6%. This study confirms that CO TOLMS is a safe and standard therapy for selected T1 and T2 glottic carcinoma, and our review on T2 glottic cancer suggests that CO TOLMS represents a reliable option in terms of overall survival, disease-specific survival, and laryngeal preservation. However, patients with anterior commissure involvement and T2 cancer should be evaluated with a preoperative MRI in order to exclude the infiltration of the laryngeal framework and to quantify the neoplastic involvement of para-glottic space.
本回顾性研究的目的是评估我们科室从 2004 年至 2016 年采用 CO TOLMS 治疗 Tis、T1 和 T2 声门肿瘤患者的结果。本分析共纳入 185 例患者，中位年龄为 67 岁（范围 42-88 岁）。患者的肿瘤分期包括 134 例 pTis-T1a、12 例 pT1b 和 39 例 pT2 病例。全研究队列的中位随访时间为 55 个月（范围 24-108 个月）。在 5 年随访时，T1a、T1b 和 T2 的局部控制率分别为 91%、83%和 79.4%。疾病特异性生存率分别为 95.5%、91.6%和 92.3%。总生存率分别为 73.8%、91.6%和 82%，喉保留率分别为 96.2%、83%和 84.6%。本研究证实 CO TOLMS 是一种安全且标准的治疗选择，适用于特定的 T1 和 T2 声门癌。我们对 T2 声门癌的回顾性研究表明，CO TOLMS 在总生存率、疾病特异性生存率和喉保留方面是一种可靠的选择。然而，对于累及前连合和 T2 癌症的患者，应进行术前 MRI 评估，以排除喉框架的浸润，并量化肿瘤对旁声门空间的累及程度。
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