Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
Department of Oncology Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Eur Arch Otorhinolaryngol. 2021 Aug;278(8):2983-2992. doi: 10.1007/s00405-020-06445-2. Epub 2021 Jan 6.
CO transoral laser microsurgery (CO2 TOLMS) is an alternative approach to non-surgical organ preservation in selected T3 glottic squamous cell carcinoma (SCC). This study aimed to assess the oncologic results and quality of life (QOL) of patients with T3 glottic SCC after CO2 TOLMS.
Of the 44 patients who underwent CO2 TOLMS, 38 underwent QOL evaluations. QOL was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 and head and neck module, Voice Handicap Index-30, and M. D. Anderson Dysphagia Inventory at least 6 months postoperatively.
The patients were predominantly male (98%), with a median age of 61 years. Cordectomy type included 1 type III, 4 type IV, 31 type V, and 8 type VI according to European Laryngological Society classification. Two patients (5%) had cervical lymph node metastasis and 21 patients (48%) underwent postoperative radiotherapy. With a mean follow-up of 65 months for all patients, 10 (23%) had tumor recurrence (9 local, 1 distant). After salvage surgery, four patients lived without disease, and the larynx was preserved in two. The 5-year local control and overall and disease-specific survival rates were 78%, 75%, and 84%, respectively. The overall laryngeal preservation rate was 82% (36/44). Most patients had satisfactory QOL.
In selected T3 glottic SCC cases, CO2 TOLMS can achieve favorable oncologic results and a satisfactory QOL.
CO 经口激光显微手术（CO2 TOLMS）是一种替代方法，用于选择性 T3 声门型鳞状细胞癌（SCC）的非手术器官保留。本研究旨在评估 T3 声门型 SCC 患者接受 CO2 TOLMS 治疗后的肿瘤学结果和生活质量（QOL）。
在接受 CO2 TOLMS 的 44 例患者中，有 38 例进行了 QOL 评估。术后至少 6 个月使用欧洲癌症研究与治疗组织生活质量问卷-C30 和头颈部模块、嗓音障碍指数-30 和 M.D.安德森吞咽障碍量表评估 QOL。
患者主要为男性（98%），中位年龄为 61 岁。根据欧洲喉科学会分类，声带切除术类型包括 1 型 III、4 型 IV、31 型 V 和 8 型 VI。2 例（5%）患者有颈部淋巴结转移，21 例（48%）患者接受术后放疗。所有患者的平均随访时间为 65 个月，10 例（23%）出现肿瘤复发（9 例局部，1 例远处）。经挽救性手术治疗后，4 例患者无病生存，2 例保留了喉。5 年局部控制率、总生存率和疾病特异性生存率分别为 78%、75%和 84%。喉总体保留率为 82%（36/44）。大多数患者的 QOL 满意。
在选择性 T3 声门型 SCC 病例中，CO2 TOLMS 可获得良好的肿瘤学结果和满意的 QOL。
