Varghese Bipin T, Mirza Abid
Head and Neck Surgical Oncology Unit, Additional Professor Head and Neck Surgery, Department of Surgical Services, Regional Cancer Centre, Trivandrum, Kerala 695011 India.
Head and Neck Surgical Oncology Unit, MCh Surgical Oncology PG Trainee, Regional Cancer Centre, Trivandrum, Kerala 695011 India.
Indian J Surg Oncol. 2020 Sep;11(3):438-445. doi: 10.1007/s13193-020-01157-9. Epub 2020 Jul 24.
Conservation laryngectomy has gained considerable acceptance as a means of enhancing overall long-term function preservation in the management of glottic cancers. This study aims to evaluate the oncological and functional outcomes of conservation surgery for carcinoma of the glottis. Fifty consecutive conservation laryngectomies from January 2010 to December 2018 were studied. Glottic cancers of stages I to IVa were carefully selected both in the primary and salvage settings after a consensus from the multidisciplinary tumour board (MDT). Oncological outcomes in terms of overall survival and disease-free survival were measured, and the long-term functional outcomes of voice and swallowing were evaluated using the GRBAS vocal scale and SWAL-QOL questionnaire. The median follow-up period was 63.4 months. The overall 5-year survival probability was 98% (standard error 2.2%), while median disease-free survival was 23 months. The median GRBAS scores in the open and transoral laser microsurgery (TOLMS) group were 1.828 and 1.428, respectively. The median SWAL-QOL scores in majority of quality of life domains were in the mild or no disease impact zone (71-100). Conservative laryngeal surgery plays a crucial role in the treatment of glottic cancers in all stages. It is oncologically safe, and the functional outcomes are favourable.
保留喉功能的喉切除术作为一种在声门癌治疗中提高整体长期功能保留率的方法,已获得广泛认可。本研究旨在评估声门癌保留手术的肿瘤学和功能学结果。对2010年1月至2018年12月连续进行的50例保留喉功能的喉切除术进行了研究。在多学科肿瘤委员会(MDT)达成共识后,对I至IVa期声门癌在初次治疗和挽救性治疗中均进行了仔细筛选。测量了总生存率和无病生存率方面的肿瘤学结果,并使用GRBAS嗓音量表和SWAL-QOL问卷评估了嗓音和吞咽的长期功能结果。中位随访期为63.4个月。5年总生存概率为98%(标准误差2.2%),而无病生存期中位值为23个月。开放手术组和经口激光显微手术(TOLMS)组的GRBAS评分中位数分别为1.828和1.428。大多数生活质量领域的SWAL-QOL评分中位数处于轻度或无疾病影响范围(71-100)。保留喉功能的手术在各期声门癌的治疗中起着关键作用。它在肿瘤学上是安全的,且功能学结果良好。