Répássy Gábor Dénes, Molnár András, Maihoub Stefani, Hargas Dóra, Tamás László
Department of Otorhinolaryngology and Head and Neck Surgery, Semmelweis University, Szigony u. 36, Budapest, H-1083, Hungary.
Department of Voice, Speech and Swallowing Therapy, Semmelweis University, Vas u. 17, Budapest, H-1088, Hungary.
Eur Arch Otorhinolaryngol. 2025 Apr;282(4):1989-2000. doi: 10.1007/s00405-025-09229-8. Epub 2025 Feb 17.
This study aimed to investigate the factors affecting laryngeal cancer survival.
This study retrospectively analysed laryngeal cancer types, treatment options, and potential factors influencing survival.
77 patients (26.27%) had supraglottic laryngeal cancer, 209 (70.13%) had glottic laryngeal cancer, and 7 (3.6%) had subglottic laryngeal cancer. Common comorbidities such as type 2 diabetes mellitus, chronic obstructive pulmonary disease, and coronary disease were observed in 13.65%, 11.9%, and 22.18% of the patients, respectively. Smoking was detected in 88.05% of the patients, while 56.3% reported regular alcohol consumption. The study found that hemilaryngectomy and supraglottic horizontal resection led to significantly longer survival compared to other treatment options (i.e., total laryngectomy, supracricoid horizontal partial laryngectomy, transoral laser cordectomy, chemoradiation, chemotherapy, and radiotherapy), p = 0.000*. Glottic cancers tend to have longer survival when considering laryngeal cancer locations; however, this difference was statistically insignificant (p = 0.640). Statistical comparisons showed significantly longer survival rates for surgical treatments in stages 1 (p = 0.007*) and 4 (p = 0.007*). Factors such as coronary artery disease, higher ECOG performance status, advanced 'N' stages, and higher tumour grades were found to significantly worsen survival, as determined by a Cox proportional hazards model.
The study revealed that factors such as coronary disease, patients' functionality, 'N' stages, and tumour grade significantly impacted survival rates. Furthermore, the study found that supraglottic horizontal resection and hemilaryngectomy resulted in the longest survival. Surgical methods were associated with significantly longer survival rates in disease stages 1 and 4.
本研究旨在调查影响喉癌生存的因素。
本研究回顾性分析了喉癌类型、治疗方案以及影响生存的潜在因素。
77例患者（26.27%）患有声门上型喉癌，209例（70.13%）患有声门型喉癌，7例（3.6%）患有声门下型喉癌。分别有13.65%、11.9%和22.18%的患者存在2型糖尿病、慢性阻塞性肺疾病和冠状动脉疾病等常见合并症。88.05%的患者检测出吸烟，而56.3%的患者报告有规律饮酒。研究发现，与其他治疗方案（即全喉切除术、环状软骨上水平部分喉切除术、经口激光声带切除术、放化疗、化疗和放疗）相比，半喉切除术和声门上水平切除术的生存期明显更长，p = 0.000*。考虑到喉癌的位置，声门型癌症的生存期往往更长；然而，这种差异在统计学上不显著（p = 0.640）。统计比较显示，1期（p = 0.007*）和4期（p = 0.007*）手术治疗的生存率明显更高。通过Cox比例风险模型确定，冠状动脉疾病、较高ECOG体能状态、晚期“N”分期和较高肿瘤分级等因素会显著降低生存率。
该研究表明，冠状动脉疾病、患者功能状态、“N”分期和肿瘤分级等因素对生存率有显著影响。此外，研究发现声门上水平切除术和半喉切除术的生存期最长。手术方法与1期和4期疾病的生存率显著延长相关。
