Xu Weiwei, Xu Jinfeng, Li Tingting, Chen Ping, Wang Yuanyuan, Guo Guangming, Huang Xiujuan
Department of Ear-Nose-Throat, Dongying People's Hospital No. 317 Nanyi Road, Dongying District, Dongying 257091, Shandong, China.
Department of Orthopedics and Traumatology, The People's Hospital of Jimo.Qingdao No. 4 Jianmin Street, Jimo District, Qingdao 266000, Shandong, China.
Am J Cancer Res. 2024 Oct 25;14(10):5105-5113. doi: 10.62347/HFTE9989. eCollection 2024.
This study aimed to evaluate the efficacy of transoral endoscopic plasma resection (TEPR) in treating early glottic laryngeal cancer (GLC) and identify prognostic factors. A retrospective analysis was conducted on the medical records of 212 patients with early GLC treated with TEPR between February 2015 and September 2018 at Dongying People's Hospital. Clinical characteristics, objective voice function changes, and clinical outcomes of the patients were analyzed. Meanwhile, Kaplan-Meier curve was plotted to assess the impact of TERP on 3- and 5-year survival in GLC patients. Additionally, univariate and multivariable logistic regression analyses were performed to assess prognostic factors for GLC recurrence, and Receiver Operating Characteristic (ROC) curves were generated to assess their predictive value for patients' prognosis. After surgery, Patients' Jitter (%), Shimmer (%) showed significant improvement from pre-surgery, in contrast to Harmonic noise ratio and maximum phonation time, which underwent a significant decrease. The study assessed success and recurrence rates over 3- and 5-year follow-up periods, revealing a disease control rate of 86.79%, with 3- and 5-year recurrence rates of 14.62% and 20.28%, respectively. Patients were categorized into favorable and unfavorable prognosis groups based on the 3-year recurrence. Univariate analysis identified significant risk factors for recurrence, including age, tumor-node-metastasis (TNM) stage, clinical stage, and cumulative anterior commissure involvement (P < 0.05). Further multivariate logistic regression confirmed the above indexes as independent risk factors impacting patient prognosis. In conclusion, TEPR effectively treats early GLC, though recurrence risk persists, with age, TNM stage, clinical stage, and anterior commissure involvement identified as prognostic risk factors, suggesting the need for targeted preventive measures in clinical practice.
本研究旨在评估经口内镜下等离子体切除术（TEPR）治疗早期声门型喉癌（GLC）的疗效并确定预后因素。对2015年2月至2018年9月期间在东营市人民医院接受TEPR治疗的212例早期GLC患者的病历进行回顾性分析。分析了患者的临床特征、客观嗓音功能变化及临床结局。同时，绘制Kaplan-Meier曲线以评估TERP对GLC患者3年和5年生存率的影响。此外，进行单因素和多因素逻辑回归分析以评估GLC复发的预后因素，并绘制受试者工作特征（ROC）曲线以评估其对患者预后的预测价值。术后，患者的抖动（%）、闪烁（%）较术前有显著改善，而谐波噪声比和最长发声时间则显著降低。该研究评估了3年和5年随访期内的成功率和复发率，疾病控制率为86.79%，3年和5年复发率分别为14.62%和20.28%。根据3年复发情况将患者分为预后良好和不良组。单因素分析确定了复发的显著危险因素，包括年龄、肿瘤-淋巴结-转移（TNM）分期、临床分期和前联合累积受累情况（P<0.05）。进一步的多因素逻辑回归证实上述指标为影响患者预后的独立危险因素。总之，TEPR可有效治疗早期GLC，但复发风险依然存在，年龄、TNM分期、临床分期和前联合受累被确定为预后危险因素，提示临床实践中需要采取针对性的预防措施。
