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T1b 声门型喉癌行前外侧垂直部分喉切除术的疗效。

Outcomes of frontolateral vertical partial laryngectomy in T1b glottic carcinomas.

机构信息

Department of Otorhinolaryngology and Plastic Surgery, RWTH Aachen University, Aachen, Germany.

出版信息

Acta Otolaryngol. 2021 Jan;141(1):99-105. doi: 10.1080/00016489.2020.1816659. Epub 2020 Sep 17.

Abstract

BACKGROUND

The treatment of T1b glottic carcinomas with invasion of the anterior commissure (AC) is still a challenge in larynx oncology. The diversity in treatment protocols is due to the difficulty in achieving safety margins of resection, especially in the AC.

OBJECTIVE

The treatment success rate of frontolateral vertical partial laryngectomy (FVPL) for the treatment of stage T1b squamous cell carcinoma of the glottic larynx infiltrating the AC.

MATERIAL AND METHODS

Clinical data of patients, who were diagnosed with stage T1b squamous cell carcinoma of the glottic larynx and who underwent a FVPL from 01/2003 to 12/2016 in our ENT clinic were retrospectively evaluated. Clinical and oncological outcomes were analyzed.

RESULTS

39 patients were included in this study. The mean follow-up duration was 79.95 ± 20.59 months. Intraoperative R0 resection was achieved in all patients. In 33.3% patients, documented complications were tissue granulation and synechia formation in the glottic area. The 5-year recurrence-free survival was 82.1%, the 5-year overall survival rate 97.4%, and the 5-year laryngeal preservation rate 94.8%.

CONCLUSION

Our clinical data demonstrate that T1b glottic carcinomas with invasion of the AC can be effectively treated with FVPL. The outcome is similar to other methods such as transoral laser microsurgery, supracricoidal partial laryngectomy, and radiotherapy.

摘要

背景

累及前联合(AC)的 T1b 声门型喉癌的治疗仍然是喉肿瘤学中的一个挑战。治疗方案的多样性是由于难以达到安全的切除边缘,特别是在 AC 处。

目的

探讨垂直前外侧喉部分切除术(FVPL)治疗累及 AC 的 T1b 声门型鳞状细胞癌的治疗成功率。

材料与方法

回顾性分析 2003 年 1 月至 2016 年 12 月期间在我院耳鼻喉科诊断为 T1b 声门型鳞状细胞癌并接受 FVPL 治疗的患者的临床资料。分析临床和肿瘤学结果。

结果

本研究共纳入 39 例患者。平均随访时间为 79.95±20.59 个月。所有患者均达到术中 R0 切除。33.3%的患者出现组织肉芽和声带粘连等并发症。5 年无复发生存率为 82.1%,5 年总生存率为 97.4%,5 年喉保留率为 94.8%。

结论

我们的临床数据表明,累及 AC 的 T1b 声门型喉癌可以通过 FVPL 有效治疗。其结果与经口激光微创手术、环状软骨上喉部分切除术和放疗等其他方法相似。

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