Hirano M, Ohkubo H, Kurita S, Hirade Y
Dept. of Otolaryngology-Head and Neck Surgery, Kurume University.
Gan To Kagaku Ryoho. 1988 Apr;15(4 Pt 2-1):881-6.
The purpose of conservation surgery is to eradicate the cancerous lesion while preserving the morphology and function of the affected organ as much as possible. Many important functions including swallowing, phonation and articulation are carried out by the organs in the head and neck. This paper presents the short-term (2 years) results of conservation surgery for carcinomas of the tongue, oropharynx, hypopharynx and larynx. Long-term results await further follow-up because of the fact that we started full use of conservation surgery rather recently. Three types of conservation surgery were applied for cancer of the tongue in 36 cases:laser surgery alone, laser debulking surgery followed by (chemo) radiotherapy and induction chemotherapy followed by laser debulking surgery and radiotherapy. The local control rate and survival rate were 97% and 88%, respectively. The basic principles of conservation surgery for oropharyngeal cancer were the same as those for cancer of the tongue. A total of 23 patients were treated, yielding a 65% local control rate and a 63% survival rate. For hypopharyngeal cancer, two types of conservation surgery were applied:partial pharyngectomy and partial laryngopharyngectomy. A total of 10 patients underwent these procedures. The local control rate was 60% and the survival rate was 70%. Two major groups of conservation surgery were applied for cancer of the larynx:laser surgery with or without radiotherapy in 74 cases and partial laryngectomy in 94 cases. The local control rate was 69% for laser surgery and 87% for partial laryngectomy, while the survival rates were 100% and 91%, respectively.
保功能手术的目的是在尽可能保留受累器官形态和功能的同时根除癌性病变。包括吞咽、发声和言语清晰等许多重要功能由头颈部器官执行。本文介绍了舌癌、口咽癌、下咽癌和喉癌保功能手术的短期(2年)结果。由于我们最近才开始充分应用保功能手术,长期结果有待进一步随访。36例舌癌患者采用了三种保功能手术方式:单纯激光手术、激光减瘤手术联合(化疗)放疗以及诱导化疗后行激光减瘤手术和放疗。局部控制率和生存率分别为97%和88%。口咽癌保功能手术的基本原则与舌癌相同。共治疗23例患者,局部控制率为65%,生存率为63%。对于下咽癌,采用了两种保功能手术方式:部分咽切除术和部分喉咽切除术。共有10例患者接受了这些手术。局部控制率为60%,生存率为70%。喉癌保功能手术主要分为两组:74例患者行激光手术联合或不联合放疗,94例患者行部分喉切除术。激光手术的局部控制率为69%,部分喉切除术的局部控制率为87%,而生存率分别为100%和91%。