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[pT3N0期喉鳞状细胞癌的临床治疗策略]

[Clinical treatment strategy for pT3N0 laryngeal squamous cell carcinoma].

作者信息

Liu Chuan, Ma Wei, Wang Zhihai, Li Yanshi, Pan Min, Zeng Quan, Hu Guohua

机构信息

Department of Otolaryngology,the First Affiliated Hospital of Chongqing Medical University,1 Yixueyuan Road,Yuzhong District,Chongqing,400016,China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jan;39(1):61-65. doi: 10.13201/j.issn.2096-7993.2025.01.013.

Abstract

To investigate optimal treatment strategy for pT3N0 laryngeal squamous cell carcinoma(SCC). A retrospective study of 150 patients with pT3N0 laryngeal SCC treated in the First Affiliated Hospital of Chongqing Medical University was performed. The efficacies of partial laryngectomy and total laryngectomy, as well as surgery alone and postoperative radiotherapy were evaluated. The overall survival(OS), disease specific survival(DSS) and disease-free survival(DFS) were analyzed with statistical package from SPSS. Among the 108 patients with glottic laryngeal SCC, there were no significant differences in OS, DSS and DFS between the partial laryngectomy group and the total laryngectomy group(Log-rank=0.184, 0.010 and 0.051, >0.05). Similarly, there were no significant differences in OS, DSS and DFS between the surgery-alone group and postoperative radiotherapy group(Log-rank=0.214, 0.251 and 0.003, >0.05). Among the 38 patients with supraglottic laryngeal SCC, the OS in the total laryngectomy group was significantly higher than that in the partial laryngectomy group(Log-rank=7.338, =0.007). The DSS and DFS in the total laryngectomy group were higher than in the partial laryngectomy group, but the differences were not statistically significant(Log-rank=0.895 and 1.792; >0.05). The DFS in the postoperative radiotherapy group was significantly higher than in the surgery-alone group(Log-rank=7.172, =0.007), but there were no significant differences in OS and DSS between these two groups(Log-rank=0.010 and 0.876, >0.05). For pT3N0 glottic laryngeal cancer patients, the efficacy of partial laryngectomy is comparable to total laryngectomy, same as surgery alone and postoperative radiotherapy. For pT3N0 supraglottic laryngeal cancer patients, total laryngectomy could improve the overall survival, and postoperative radiotherapy could reduce the recurrence. Prospectively randomized study with large samples is still needed.

摘要

探讨pT3N0喉鳞状细胞癌(SCC)的最佳治疗策略。对重庆医科大学附属第一医院收治的150例pT3N0喉SCC患者进行回顾性研究。评估了部分喉切除术和全喉切除术以及单纯手术和术后放疗的疗效。采用SPSS统计软件分析总生存期(OS)、疾病特异性生存期(DSS)和无病生存期(DFS)。在108例声门型喉SCC患者中,部分喉切除术组与全喉切除术组的OS、DSS和DFS无显著差异(对数秩检验=0.184、0.010和0.051,>0.05)。同样,单纯手术组与术后放疗组的OS、DSS和DFS也无显著差异(对数秩检验=0.214、0.251和0.003,>0.05)。在38例声门上型喉SCC患者中,全喉切除术组的OS显著高于部分喉切除术组(对数秩检验=7.338,P=0.007)。全喉切除术组的DSS和DFS高于部分喉切除术组,但差异无统计学意义(对数秩检验=0.895和1.792;>0.05)。术后放疗组的DFS显著高于单纯手术组(对数秩检验=7.172,P=0.007),但两组的OS和DSS无显著差异(对数秩检验=0.010和0.876,>0.05)。对于pT3N0声门型喉癌患者,部分喉切除术的疗效与全喉切除术相当,单纯手术与术后放疗也是如此。对于pT3N0声门上型喉癌患者,全喉切除术可提高总生存期,术后放疗可降低复发率。仍需进行大样本的前瞻性随机研究。

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