Zhou Jian, Xu Cheng-Zhi, Zhu Xiao-Ke, Yang Yue, Zhou Liang, Gong Hong-Li, Tao Lei
Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital Fudan University Shanghai China.
World J Otorhinolaryngol Head Neck Surg. 2024 Mar 31;11(1):29-36. doi: 10.1002/wjo2.168. eCollection 2025 Mar.
The research aimed to evaluate the clinical treatment outcomes of T2N0M0 glottic laryngeal squamous cell carcinoma (LSCC) patients who underwent laryngectomy.
Retrospective review of 533 T2N0M0 glottic LSCC patients.
Five-year cancer-specific survival (CSS) rate was 90.0%, and the overall survival (OS) rate was 89.1%. No statistically difference was found between the patients who have undergone total laryngectomy (5-year disease-free survival[DFS] = 80.7%, and the CSS = 86.7%) and those who have had partial laryngectomy (the 5-year DFS = 85.3%, and CSS = 91.1%). There was no difference in the CSS and DFS rates between patients with negative margins and those with positive margins following postoperative radiotherapy (PORT) ± chemotherapy (the CSS: 90.8% vs. 81.8%, = 0.458 and 5-year DFS: 84.6% vs. 79.5%, = 0.371). Patients who underwent vertical partial laryngectomy (VPL) had better survival (5-year OS was 91.9%, and the CSS was 92.8%) than those who underwent cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) (the 5-year OS = 83.8%, = 0.022 and CSS = 84.9%, = 0.038).
Surgery remains the gold standard for treating T2N0M0 glottic LSCC patients because it can achieve satisfactory oncological outcomes. Regarding the systemic conditions, the effect of partial laryngectomy is similar to that of total laryngectomy. Moreover, partial laryngectomy preserves the function of the larynx. VPL may be superior to CHP/CHEP, depending upon the invasiveness of the tumor.
本研究旨在评估接受喉切除术的T2N0M0声门型喉鳞状细胞癌（LSCC）患者的临床治疗效果。
回顾性分析533例T2N0M0声门型LSCC患者。
5年癌症特异性生存率（CSS）为90.0%，总生存率（OS）为89.1%。全喉切除术患者（5年无病生存率[DFS]=80.7%，CSS=86.7%）与部分喉切除术患者（5年DFS=85.3%，CSS=91.1%）之间未发现统计学差异。术后放疗（PORT）±化疗后切缘阴性和切缘阳性的患者在CSS和DFS率上无差异（CSS：90.8%对81.8%，P=0.458；5年DFS：84.6%对79.5%，P=0.371）。接受垂直部分喉切除术（VPL）的患者生存率（5年OS为91.9%，CSS为92.8%）优于接受环状软骨舌骨会厌固定术（CHEP）或环状软骨舌骨固定术（CHP）的患者（5年OS=83.8%，P=0.022；CSS=84.9%，P=0.038）。
手术仍然是治疗T2N0M0声门型LSCC患者的金标准，因为它可以取得令人满意的肿瘤学效果。就全身情况而言，部分喉切除术的效果与全喉切除术相似。此外，部分喉切除术保留了喉的功能。根据肿瘤的侵袭性，VPL可能优于CHP/CHEP。
