经内镜喉咽手术治疗的同步多发原发性声门上型喉咽癌的评估。
Evaluation of synchronous multiple primary superficial laryngo-pharyngeal cancers that were treated by endoscopic laryngo-pharyngeal surgery.
机构信息
Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
出版信息
Auris Nasus Larynx. 2021 Dec;48(6):1162-1166. doi: 10.1016/j.anl.2021.03.022. Epub 2021 Apr 21.
OBJECTIVE
ndoscopic laryngopharyngeal surgery (ELPS) is a useful surgery for superficial cancers of the head and neck region, but it has not yet been well evaluated for synchronous multiple primary cancers (multiple primaries). The purpose of this study was to clarify the safety and usefulness of ELPS for patients with multiple superficial primary cancers in the head and neck region.
METHODS
rom December 2009 to December 2016, 145patients with superficial head and neck cancers underwent ELPS. The patients were divided into two groups; a group consisting of patients with a single primary cancer (single primary) and another group consisting of patients with synchronous multiple primaries, and the incidences of postoperative complications and lymph node metastasis were retrospectively compared between the two groups.
RESULTS
f the 145 patients, 107 had a single primary cancer and 38 had multiple primaries. There was no significant difference in the age, sex, or rate of intraepithelial cancer between the two groups. Postoperative complications included dysphagia in 6 (5.6%) patients with a single primary and 2 (5.3%) patients with multiple primaries. One patient with multiple primaries required gastrostomy because of aspiration pneumonia. In addition, the following complications were also observed. Laryngeal paralysis occurred in 2 (1.9%) patients with a single primary, and 1 (2.6%) patient with multiple primaries; tracheostomy because of postoperative bleeding in 1 (0.9%) patient with a single primary; infection occurred in 2 (5.3%) patients with multiple primaries. Postoperative lymph node metastasis was found in 7 (6.5%) patients with a single primary and 6 (15.8%) patients with multiple primaries. Lymphatic invasion of the primary cancer was noted in 3 (2.8%) patients with a single primary and 5 (13.2%) patients with multiple primaries, being significantly higher in the latter group.
CONCLUSION
ELPS is also a safe surgery for patients with multiple primaries. However, the incidence of lymphatic invasion of the primary cancer was significantly higher in patients with multiple primaries.
目的
内镜喉咽手术（ELPS）是一种用于头颈部浅表癌症的有用手术，但对于同时发生的多原发癌（multiple primaries）尚未得到很好的评估。本研究的目的是阐明 ELPS 治疗头颈部同时发生的多个浅表原发性癌症患者的安全性和实用性。
方法
2009 年 12 月至 2016 年 12 月，145 例头颈部浅表癌症患者接受了 ELPS。将患者分为两组；一组为单发原发性癌症患者（单发组），另一组为同时发生多个原发性癌症患者（多发组），回顾性比较两组患者术后并发症和淋巴结转移的发生率。
结果
145 例患者中，107 例为单发原发性癌症，38 例为多发原发性癌症。两组患者的年龄、性别和上皮内癌发生率无显著差异。术后并发症包括单发组 6 例（5.6%）和多发组 2 例（5.3%）吞咽困难。1 例多发组患者因吸入性肺炎而行胃造口术。此外，还观察到以下并发症。单发组 2 例（1.9%）发生喉麻痹，多发组 1 例（2.6%）发生喉麻痹；单发组 1 例（0.9%）因术后出血行气管切开术；多发组 2 例（5.3%）发生感染。单发组 7 例（6.5%）和多发组 6 例（15.8%）患者术后发现淋巴结转移。单发组 3 例（2.8%）和多发组 5 例（13.2%）原发性癌症有淋巴浸润，后者明显更高。
结论
ELPS 对多发原发性癌症患者也是一种安全的手术。然而，多发原发性癌症患者原发性癌症的淋巴浸润发生率明显更高。
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