Tzelnick Sharon, de Almeida John R, Gilbert Ralph, Goldstein David
Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada.
Department of Surgical Oncology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada.
OTO Open. 2024 Aug 18;8(3):e179. doi: 10.1002/oto2.179. eCollection 2024 Jul-Sep.
Treatment options for recurrent early glottic carcinoma's include conservative and radical surgical options. These options offer similar survival benefits with different impacts of patient's quality of life. We previously present our experience with vertical partial laryngectomy (VPL) and showed high locoregional control rates with high-quality voice results and normal swallowing.
A long-term retrospective review.
Tertiary Care Center.
We analyzed all patients underwent VPL between the years 1995 to 2018. Long-term oncologic and functional outcomes were collected.
A total of 40 patients were included. The majority of whom were male (n = 38, 95%) with a mean age of 64.9 years (SD ± 9.5). With a median follow up time of 12 years (range 0-24), 9 patients (22.5%) had disease recurrence; the majority of whom (8 patients), had local recurrence and all were salvaged with total laryngectomy. Eight patients (20%) developed second primaries in the head and neck region with a median time to diagnosis of 77 months (range 8-227 months). Ten-years overall survival, disease specific survival, and local disease-free survival were 80%, 90%, and 80%, respectively. Five patients had postoperative laryngeal dysfunction with a total 10-years laryngectomy free survival of 70%.
VPL has a sustainable oncologic outcome with a high long-term laryngectomy free survival rate. This entity is an acceptable conservative salvage option for selected postradiated recurrent laryngeal squamous cell carcinoma patients.
复发性早期声门癌的治疗选择包括保守性和根治性手术方案。这些方案在生存率方面相似，但对患者生活质量的影响不同。我们之前介绍了我们进行垂直部分喉切除术（VPL）的经验，显示出较高的局部区域控制率，同时语音质量高且吞咽正常。
长期回顾性研究。
三级医疗中心。
我们分析了1995年至2018年间所有接受VPL的患者。收集了长期的肿瘤学和功能结果。
共纳入40例患者。其中大多数为男性（n = 38，95%），平均年龄64.9岁（标准差±9.5）。中位随访时间为12年（范围0 - 24年），9例患者（22.5%）疾病复发；其中大多数（8例）为局部复发，所有患者均通过全喉切除术挽救。8例患者（20%）在头颈部区域发生第二原发肿瘤，诊断的中位时间为77个月（范围8 - 227个月）。10年总生存率、疾病特异性生存率和局部无病生存率分别为80%、90%和80%。5例患者术后出现喉功能障碍，10年无喉切除术生存率总计为70%。
VPL具有可持续的肿瘤学结果，长期无喉切除术生存率高。对于部分接受放疗后的复发性喉鳞状细胞癌患者，该术式是一种可接受的保守挽救选择。
