Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei.
National Yang Ming Chiao Tung University, Taipei.
Otolaryngol Head Neck Surg. 2022 Nov;167(5):839-845. doi: 10.1177/01945998221075317. Epub 2022 Feb 15.
Transoral laser microsurgery and radiotherapy provide high and comparable cure rates for the treatment of early glottic cancer. However, the voice outcomes after treatment remain controversial. A modified type III cordectomy technique was proposed in 2006, and preliminary results showed it to be an oncologically safe method with satisfactory voice outcomes. This study aimed to evaluate oncologic and voice outcomes after long-term follow-up of these patients.
Retrospective cohort study.
Tertiary care academic center.
Between 2006 and 2018, 42 patients with glottic cancer underwent a modified type III cordectomy. This technique resected the tumor and upper part of the vocal folds and preserved the lower part of the vocalis muscle as a scaffold to improve glottis closure. The oncologic results and voice outcomes were evaluated at a median follow-up of 68 months.
The primary tumor stages included 13 T1 (31%), 26 T2 (64%), and 3 T3 (7%). Eight patients (19%) had local recurrence, and 6 underwent successful salvage with transoral laser microsurgery with or without postoperative radiotherapy with laryngeal preservation. The 5-year rate of local control was 80%; laryngeal preservation, 95%; overall survival, 89%; and disease-specific survival, 97%. The final laryngeal preservation rate was 95% (40/42). The voice outcomes were satisfactory and comparable to those of patients who underwent type I and II cordectomies.
The modified type III cordectomy has been proven to be an oncologically safe method with satisfactory voice outcomes after long-term follow-up in selected cases of early glottic cancer.
经口激光显微手术和放疗为早期声门型癌症的治疗提供了高且相当的治愈率。然而，治疗后的嗓音结果仍存在争议。2006 年提出了一种改良的 III 型声带切除术技术，初步结果表明该技术是一种具有满意嗓音结果的肿瘤安全性方法。本研究旨在评估这些患者长期随访后的肿瘤学和嗓音结果。
回顾性队列研究。
三级保健学术中心。
2006 年至 2018 年期间，42 例声门型癌症患者接受了改良的 III 型声带切除术。该技术切除肿瘤和声带的上部，并保留声门下肌的下部作为支架，以改善声门闭合。在中位随访 68 个月时评估肿瘤学结果和嗓音结果。
原发性肿瘤分期包括 13 例 T1（31%）、26 例 T2（64%）和 3 例 T3（7%）。8 例（19%）患者出现局部复发，6 例患者成功接受挽救性经口激光显微手术治疗，伴或不伴保留喉的术后放疗。5 年局部控制率为 80%；喉保留率为 95%；总生存率为 89%；疾病特异性生存率为 97%。最终的喉保留率为 95%（40/42）。嗓音结果令人满意，与接受 I 型和 II 型声带切除术的患者相当。
在选择的早期声门型癌症病例中，长期随访证实改良的 III 型声带切除术是一种肿瘤安全性方法，具有满意的嗓音结果。
