Department of Otorhinolaryngology - Head and Neck Surgery, 'G. Papanikolaou' General Hospital, Thessaloniki, Greece.
Department of Otorhinolaryngology - Head and Neck Surgery, Derriford Hospital University Hospitals Plymouth NHS Trust, Plymouth, UK.
J Laryngol Otol. 2021 Aug;135(8):729-736. doi: 10.1017/S0022215121001687. Epub 2021 Jul 5.
The purpose of this study was to evaluate the outcome of salvage total laryngectomy and identify areas for further improvement.
A retrospective analysis of all patients who underwent salvage total laryngectomy between January 1999 and December 2018 was performed.
Thirty-one patients were identified. The most common primary tumour site was the glottis (83.8 per cent). Early stage (T1-T2) disease was identified in 83.9 per cent of cases. Overall survival at 2 and 5 years post-salvage total laryngectomy was 71 per cent and 45 per cent, respectively. Disease-free survival at 2 and 5 years post-salvage total laryngectomy was 65 per cent and 42 per cent, respectively. The rate of post-salvage total laryngectomy pharyngocutaneous fistula was 29 per cent.
More than half of patients will not survive beyond five years after salvage total laryngectomy. Regional recurrence was the most common form of failure and death. From this study, elective lateral and central neck dissection is advocated in patients with early laryngeal cancer who present with an advanced recurrence.
本研究旨在评估挽救性全喉切除术的结果，并确定进一步改进的领域。
对 1999 年 1 月至 2018 年 12 月期间所有接受挽救性全喉切除术的患者进行回顾性分析。
确定了 31 例患者。最常见的原发肿瘤部位是声门（83.8%）。83.9%的病例为早期（T1-T2）疾病。挽救性全喉切除术后 2 年和 5 年的总生存率分别为 71%和 45%。挽救性全喉切除术后 2 年和 5 年的无病生存率分别为 65%和 42%。挽救性全喉切除术后咽皮瘘的发生率为 29%。
超过一半的患者在挽救性全喉切除术后五年后无法存活。区域复发是最常见的失败和死亡形式。本研究提倡对有晚期复发的早期喉癌患者进行选择性侧颈部和中央颈部清扫术。
