喉腺样囊性癌：根治性还是保守性手术？
Laryngeal adenoid cystic carcinoma: Radical or conservative surgery?
机构信息
Otolaryngology Unit, Vittorio Veneto - Conegliano Hospital, Treviso, Italy.
Pathology Unit, Vittorio Veneto - Conegliano Hospital, Treviso, Italy.
出版信息
Am J Otolaryngol. 2021 Jul-Aug;42(4):102974. doi: 10.1016/j.amjoto.2021.102974. Epub 2021 Feb 16.
PURPOSE
The present paper describes our experience in surgical treatment of laryngeal ACC, and discuss the effectiveness of conservative surgery.
METHODS
We retrospectively reviewed the clinical charts of 17 patients with laryngeal ACC treated surgically at the Otolaryngology Unit of Vittorio Veneto Hospital (Italy) from November 1989 to April 2020.
RESULTS
Fourteen patients underwent partial laryngectomy, and three had a total laryngectomy. Five patients (29%) experienced a laryngeal ACC relapse after a disease-free survival of 66.6 ± 50.1 months. The distant metastasis rate was 17%. At latest follow-up, two patients had died of distant metastatic disease after 156 and 243 months.
CONCLUSIONS
Radical surgery for laryngeal ACC does not warrant free margins and even cases with positive deep margins rarely experience any relapsing disease. We recommend that surgical treatment for laryngeal ACC be as conservative as possible.
目的
本文描述了我们在喉咽腺样囊性癌（laryngeal ACC）的外科治疗方面的经验，并探讨了保守手术的疗效。
方法
我们回顾性分析了 1989 年 11 月至 2020 年 4 月期间在意大利维托里奥威内托医院耳鼻喉科接受手术治疗的 17 例喉咽 ACC 患者的临床资料。
结果
14 例患者接受了部分喉切除术，3 例患者接受了全喉切除术。5 例患者（29%）在无疾病生存 66.6±50.1 个月后出现喉咽 ACC 复发。远处转移率为 17%。末次随访时，2 例患者分别在 156 个月和 243 个月后死于远处转移疾病。
结论
对于喉咽 ACC 进行根治性手术并不需要保证切缘无肿瘤，即使是深部切缘阳性的病例也很少出现复发疾病。我们建议对喉咽 ACC 进行尽可能保守的手术治疗。
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