Lee Changseok, Forner David, Noel Christopher W, Taylor Victoria, MacKay Colin, Rigby Matthew H, Corsten Martin, Trites Jonathan R, Taylor S Mark
Division of Otolaryngology-Head and Neck Surgery, Queen Elizabeth II Health Sciences Center and Dalhousie University, Halifax, Canada.
Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada.
OTO Open. 2021 Sep 29;5(3):2473974X211046957. doi: 10.1177/2473974X211046957. eCollection 2021 Jul-Sep.
To evaluate the oncologic and functional outcomes of transoral laser microsurgery (TLM) for glottic cancers in patients ≥80 years.
Prospectively collected case series.
QEII Health Sciences Centre, Halifax, Canada.
This case series used a prospectively collected glottic cancer database to examine consecutive elderly patients (≥80 years old) undergoing TLM. Kaplan-Meier analysis was used to evaluate rates of disease-free, disease-specific, and overall survival as the primary end points of oncologic control. Secondary functional outcomes included voice function, length of hospital stay, and time to readmission.
From 2005 to 2017, 17 octogenarian patients underwent TLM for glottic cancer. Median follow-up was 4.19 years (interquartile range, 0.71-6.95). Kaplan-Meier estimates of 5-year survival were 78.4% (disease free), 92.9% (disease specific), and 81.9% (overall). The median length of hospital stay was 1 day (range, 0-8). There was only 1 readmission within 30 days of surgery. No patients in this study developed significant surgical or postoperative complications requiring unplanned readmissions. Patient-perceived voice function improved to normal after treatment in 62.5% of patients.
The results of this study suggest that TLM is a safe and effective treatment modality for glottic cancer in patients aged ≥80 years, providing good oncologic control and satisfactory functional outcomes.
评估经口激光显微手术（TLM）治疗80岁及以上声门癌患者的肿瘤学和功能结局。
前瞻性收集的病例系列。
加拿大哈利法克斯的QEII健康科学中心。
本病例系列使用前瞻性收集的声门癌数据库，对接受TLM的连续老年患者（≥80岁）进行研究。采用Kaplan-Meier分析评估无病生存率、疾病特异性生存率和总生存率，作为肿瘤学控制的主要终点。次要功能结局包括语音功能、住院时间和再入院时间。
2005年至2017年，17例八旬老人接受了声门癌的TLM治疗。中位随访时间为4.19年（四分位间距，0.71 - 6.95）。Kaplan-Meier估计的5年生存率分别为：无病生存率78.4%，疾病特异性生存率92.9%，总生存率81.9%。中位住院时间为1天（范围，0 - 8天）。术后30天内仅有1例再入院。本研究中没有患者出现需要计划外再入院的严重手术或术后并发症。62.5%的患者在治疗后患者自我感觉语音功能恢复正常。
本研究结果表明，TLM是治疗80岁及以上声门癌患者的一种安全有效的治疗方式，可提供良好的肿瘤学控制和令人满意的功能结局。
