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开放性部分喉切除术与经口激光手术治疗声门上型喉癌的功能及肿瘤学结局

Functional and Oncological Outcomes of Open Partial Laryngectomy vs. Transoral Laser Surgery in Supraglottic Larynx Cancer.

作者信息

Gökmen Muhammet Fatih, Büyükatalay Zahide Çiler, Beton Süha, Gökcan Mustafa Kürşat, Dursun Gürsel, Meço Cem, Küçük Tarık Babür

机构信息

Department of Otorhinolaryngology, Ankara University School of Medicine, Ankara, Turkey.

出版信息

Turk Arch Otorhinolaryngol. 2020 Dec;58(4):227-233. doi: 10.5152/tao.2020.5573. Epub 2020 Dec 1.

Abstract

OBJECTIVE

The aim of the presented study was to evaluate the outcomes of open partial laryngectomy (OPL) versus transoral laser surgery (TLS) in patients operated on for supraglottic laryngeal carcinoma based on functional parameters (duration of hospitalization, oral nutritional status and duration of transition to oral feeding, weaning status and duration after tracheotomy, and postoperative voice results) and oncological results (overall survival rate, disease-specific survival rate, recurrence, and presence of second primary tumors) in both groups.

METHODS

All laryngeal carcinoma patients who had undergone either OPL or TLS in the period from January 2012 to March 2017 in our center and were followed-up at least for 36 months were included in the study. Statistical analyses were carried out using the t-test and the Mann-Whitney U test to compare the means, and the Kaplan-Meier test for survival analysis.

RESULTS

Fifty patients (44 males and 6 females) met the study criteria, of whom 31 had undergone OPL and 19 TLS. Patients that underwent TLS had less tracheotomy needs, needed shorter hospitalization periods, and transitioned to oral feeding earlier, compared to those that underwent OPL. There were no significant differences between the two groups based on oral feeding rates and voice outcomes. The impact of TLS and OPL on organ preservation in supraglottic laryngeal cancer were comparable. For local recurrences, repeated endolaryngeal laser surgeries and adjuvant treatments could be used in the TLS patient group. There were no significant differences between the two groups based on overall survival rate and disease specific survival rate.

CONCLUSION

Although no significant differences were found in our study between the two surgical procedures in terms of oncological outcomes, TLS appeared to produce better functional outcomes in supraglottic laryngeal carcinoma than OPL.

摘要

目的

本研究旨在基于功能参数(住院时间、口腔营养状况及过渡至经口进食的时间、脱机状态及气管切开术后持续时间、术后嗓音结果)和肿瘤学结果(总生存率、疾病特异性生存率、复发情况及第二原发肿瘤的存在情况),评估声门上型喉癌患者接受开放性部分喉切除术(OPL)与经口激光手术(TLS)的疗效。

方法

纳入2012年1月至2017年3月在本中心接受OPL或TLS手术且至少随访36个月的所有喉癌患者。采用t检验和曼-惠特尼U检验进行统计分析以比较均值,采用Kaplan-Meier检验进行生存分析。

结果

50例患者(44例男性,6例女性)符合研究标准,其中31例行OPL,19例行TLS。与接受OPL的患者相比,接受TLS的患者气管切开需求更少,住院时间更短,且更早过渡至经口进食。两组在经口进食率和嗓音结果方面无显著差异。TLS和OPL对声门上型喉癌器官保留的影响相当。对于局部复发,TLS患者组可采用重复的喉内激光手术和辅助治疗。两组在总生存率和疾病特异性生存率方面无显著差异。

结论

尽管本研究中两种手术方法在肿瘤学结果方面未发现显著差异,但TLS在声门上型喉癌中似乎比OPL产生更好的功能结果。

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