Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Am J Otolaryngol. 2022 Nov-Dec;43(6):103551. doi: 10.1016/j.amjoto.2022.103551. Epub 2022 Jul 29.
The oncologic outcomes between transoral laser microsurgery (TLM) and open partial laryngectomy (OPL) using comprehensive analysis in one clinical center is rare. The purpose of this study was to evaluate the oncologic outcomes of TLM in patients with early stage glottic carcinoma, and to compare the results with OPL.
Records of 425 glottic carcinoma patients with T1 - T2 stage treated with TLM, vertical partial laryngectomy (VPL), and cricohyoidoepiglottopexy (CHEP) from 2005 to 2010 were retrospectively analyzed. The overall survival (OS), disease-specific survival (DSS), and laryngeal function preservation (LFP) of these three treatments were assessed.
One hundred and twenty-two patients were treated with TLM. Regarding OPL, 167 patients underwent VPL, and 136 patients underwent CHEP. The mean age was 59.7 years, with men accounting for 97.2 % of all cases. The OS, DSS, and LFP rates of patients with anterior commissure (AC) involvement undergoing TLM were worse than those of patients without AC involvement, but these differences were not statistically significant. The 5-year OS, DSS, and LFP of patients undergoing TLM were 88.4 %, 89.9 %, and 83.5 %, respectively, and the oncologic outcomes of patients undergoing TLM, VPL, and CHEP were not statistically different.
Glottic carcinoma patients with early stage treated with TLM experience satisfactory oncologic outcomes. No compelling difference in oncologic outcomes among three treatments of TLM, VPL and CHEP, as well as VPL and CHEP can be alternatives to patients who are not suitable for receiving TLM.
在单一临床中心进行综合分析，经口激光微创手术（TLM）与开放性部分喉切除术（OPL）之间的肿瘤学结果鲜有报道。本研究旨在评估 TLM 治疗早期声门型喉癌的肿瘤学结果，并与 OPL 进行比较。
回顾性分析了 2005 年至 2010 年间，425 例 T1-T2 期声门型喉癌患者接受 TLM、垂直部分喉切除术（VPL）和环状软骨-舌骨会厌固定术（CHEP）的病例。评估了这三种治疗方法的总生存率（OS）、疾病特异性生存率（DSS）和喉功能保留率（LFP）。
122 例患者接受了 TLM 治疗。关于 OPL，167 例患者接受了 VPL，136 例患者接受了 CHEP。平均年龄为 59.7 岁，所有病例均为男性，占 97.2%。前联合（AC）受累患者行 TLM 的 OS、DSS 和 LFP 率均差于未受累患者，但差异无统计学意义。行 TLM 患者的 5 年 OS、DSS 和 LFP 分别为 88.4%、89.9%和 83.5%，行 TLM、VPL 和 CHEP 患者的肿瘤学结果无统计学差异。
早期声门型喉癌患者行 TLM 治疗可获得满意的肿瘤学结果。TLM、VPL 和 CHEP 三种治疗方法之间，以及 VPL 和 CHEP 之间的肿瘤学结果无明显差异，可作为不适合接受 TLM 治疗的患者的替代方案。
