Osuch-Wójcikiewicz Ewa, Majszyk Daniel, Bruzgielewicz Antoni, Grochowiecki Tadeusz, Nazarewski Sławomir, Chęciński Piotr, Niemczyk Kazimierz
Department of Otorhinolaryngology Head and Neck Surgery, Medical University in Warsaw, Warsaw, Poland.
Department of General, Vascular and Transplant Surgery, Medical University in Warsaw, Warsaw, Poland.
Contemp Oncol (Pozn). 2021;25(1):28-32. doi: 10.5114/wo.2021.105074. Epub 2021 Apr 15.
Hypopharyngeal cancer accounts for 3-5% of all squamous-cell carcinoma (SCC) of the head and neck and has one of the worst prognoses. The aim of the study was to evaluate oncologic and functional treatment outcomes in patients with T3-T4a squamous cell hypopharyngeal and laryngeal cancer.
Retrospective analysis of the material from one treatment site included 90 patients (81 male, 9 female) who had undergone surgery between 1986 and 2010. Their mean age was 55.06 years (range 36-75).
TNM (T - tumour, N - node, M - metastasis) staging assessment was feasible in 70 treatment-naïve patients (77.78%): 57 (63.33%) were classified to stage T4a, and 13 were classified to T3 (14.44%). Cervical lymphadenopathy was observed in 53 (63.3%) patients; in 44 patients (48.89%) postoperative histopathology confirmed metastatic disease. G2 or G3 SCC was detected in 80% of patients. All patients underwent laryngopharyngoesophagectomy (LPE). Digestive tract reconstruction was performed using one of two methods: jejunal autograft (JA) in 79 patients (87.78 %) - Group A or ileocolic autograft (IA) in 11 patients (12.22%) - Group B. Comparative statistical analysis of both groups showed statistically significant differences only for substitute speech production. The mean survival time of patients from both groups was 2.21 years after reconstruction surgery.
JA or IA for digestive tract reconstruction in patients after LPE are burdened with high risk of complications but offer patients the chance of a normal oral diet shortly after surgery. Ileocolic autograft enables rapid production of substitute speech.
下咽癌占头颈部所有鳞状细胞癌（SCC）的3% - 5%，预后最差。本研究的目的是评估T3 - T4a期下咽鳞状细胞癌和喉癌患者的肿瘤学和功能治疗结果。
对来自一个治疗地点的材料进行回顾性分析，纳入了1986年至2010年间接受手术的90例患者（81例男性，9例女性）。他们的平均年龄为55.06岁（范围36 - 75岁）。
70例初治患者（77.78%）可行TNM（T - 肿瘤，N - 淋巴结，M - 转移）分期评估：57例（63.33%）被分类为T4a期，13例被分类为T3期（14.44%）。53例（63.3%）患者观察到颈部淋巴结肿大；44例患者（48.89%）术后组织病理学证实有转移性疾病。80%的患者检测到G2或G3 SCC。所有患者均接受喉咽食管切除术（LPE）。采用两种方法之一进行消化道重建：79例患者（87.78%）采用空肠自体移植（JA）——A组，11例患者（12.22%）采用回结肠自体移植（IA）——B组。两组的比较统计分析显示，仅在替代语音产生方面存在统计学显著差异。重建手术后两组患者的平均生存时间为2.21年。
LPE术后患者采用JA或IA进行消化道重建并发症风险高，但为患者提供了术后不久即可正常经口饮食的机会。回结肠自体移植能够快速产生替代语音。
