Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education of China, Beijing Institute of Otolaryngology, Beijing, China.
Acta Otolaryngol. 2021 Sep;141(9):860-864. doi: 10.1080/00016489.2021.1925958. Epub 2021 Sep 26.
The incidence of local recurrence after transoral CO laser microsurgery for T1b-T2 glottic carcinoma is relatively low. Multiple risk factors have been described for the development of local recurrence after treatment. However, to date, there is no analysis or systematic review investigating the relationships between clinical and histopathological factors and the appearance of local recurrence after transoral CO laser microsurgery in T1b-T2 glottic carcinoma patients.
AIMS/OBJECTIVE: To investigate risk factors for local recurrence after CO laser surgery in T1b-T2 glottic carcinoma involving bilateral vocal cords.
We retrospectively studied patients undergoing CO laser surgery for T1b-T2 glottic carcinoma involving bilateral vocal cords. Multiple follow-up laryngoscopies and computed tomographies were performed. Main outcome measures: survival rate, local recurrence rate, and independent risk factors for recurrence.
All 85 patients (83 male; age, 63.33 ± 10.59 years; 36 T1b and 49 T2 lesions; 28 cases with and 57 without anterior commissure (AC) involvement) survived; 15 exhibited postoperative local recurrence. Recurrence rates differed between the following groups: patients without (6/57) versus patients with AC involvement (9/28) ( = .007); patients with negative (11/77) versus positive resection margins (4/8) ( = .014); p53-negative (5/51) versus p53-positive patients (10/34) ( = .0132). AC involvement, positive resection margins, and p53 expression were independent risk factors for recurrence.
Patients with stage T1b and T2 glottic carcinoma with AC involvement, positive resection margins, and p53 expression should be followed up at shorter intervals.
This article provided valid clinical data for risk factors for local recurrence after CO laser surgery for T1b-T2 glottic carcinoma involving bilateral vocal cords.
经口 CO2 激光显微手术治疗 T1b-T2 声门型喉癌的局部复发率相对较低。治疗后局部复发的发生与多种危险因素有关。然而，迄今为止，尚无分析或系统评价研究 T1b-T2 声门型喉癌患者经口 CO2 激光显微手术后临床和组织病理学因素与局部复发之间的关系。
目的/目标：探讨双侧声带受累 T1b-T2 声门型喉癌 CO2 激光手术后局部复发的危险因素。
我们回顾性研究了经 CO2 激光手术治疗双侧声带受累 T1b-T2 声门型喉癌的患者。进行了多次随访喉镜和计算机断层扫描。主要观察指标：生存率、局部复发率和复发的独立危险因素。
85 例患者（83 例男性；年龄 63.33±10.59 岁；36 例 T1b 期病变和 49 例 T2 期病变；28 例有前连合（AC）受累，57 例无 AC 受累）均存活；15 例术后出现局部复发。以下各组之间的复发率不同：无 AC 受累患者（57 例中有 6 例）与有 AC 受累患者（28 例中有 9 例）（ = .007）；阴性切缘患者（77 例中有 11 例）与阳性切缘患者（8 例中有 4 例）（ = .014）；p53 阴性患者（51 例中有 5 例）与 p53 阳性患者（34 例中有 10 例）（ = .0132）。AC 受累、阳性切缘和 p53 表达是复发的独立危险因素。
T1b 和 T2 期声门型喉癌患者双侧声带受累、阳性切缘和 p53 表达者应缩短随访间隔。
本文为 CO2 激光治疗双侧声带受累 T1b-T2 声门型喉癌后局部复发的危险因素提供了有效的临床数据。
