经口二氧化碳激光显微手术治疗喉癌的性别差异：一项病例对照研究。
Sex differences in laryngeal cancer treated with COtransoral laser microsurgery: a case-control study.
作者信息
Vilaseca Isabel, Sampieri C, Lehrer E, Ramírez R D, Costa J M, Valduvieco I, Basté N, Medrano S, Rodriguez Y, Muxí A, Avilés-Jurado F X, Bernal-Sprekelsen M
机构信息
Otorhinolaryngology Department, Hospital Clínic, Barcelona, Spain.
Surgical Area. Hospital Clínic, Barcelona, Spain.
出版信息
Eur Arch Otorhinolaryngol. 2025 May;282(5):2493-2505. doi: 10.1007/s00405-025-09315-x. Epub 2025 Mar 14.
BACKGROUND
The aim of the present study was to evaluate the sex-disparities in larynx cancer patients treated with COTransoral Laser Microsurgery (CO-TOLMS).
METHODS
Retrospective analysis of 1290 consecutive patients. Oncologic and functional outcomes were evaluated according to sex groups. Survival rates were compared by propensity-score matching approach and multivariable Cox regression analysis.
RESULTS
Among 1290 patients, 122 (9.5%) were females. No significant differences were observed in tumor exposure, margins or pathology characteristics. Women experienced fewer complications than men (0.12 vs. 0.06; p = 0.007). There were neither significant differences in voice or swallowing outcomes, nor in the need for tracheostomy or gastrostomy. 5-y disease-free (63% vs. 66%, p = 0.92), 5-y disease-specific (91% vs. 93%, p = 0.54) and 5-y overall survival (78% vs. 84%, p = 0.18) rates were not different between men and woman.
CONCLUSIONS
CO-TOLMS is a valid treatment for larynx cancer in women, with equivalent outcomes than those achieved in the male population.
背景
本研究旨在评估接受二氧化碳经口激光显微手术（CO-TOLMS）治疗的喉癌患者的性别差异。
方法
对1290例连续患者进行回顾性分析。根据性别分组评估肿瘤学和功能结局。采用倾向评分匹配法和多变量Cox回归分析比较生存率。
结果
在1290例患者中，122例（9.5%）为女性。在肿瘤暴露、切缘或病理特征方面未观察到显著差异。女性的并发症比男性少（0.12对0.06；p = 0.007）。在声音或吞咽结局、气管切开术或胃造口术需求方面均无显著差异。男性和女性的5年无病生存率（63%对66%，p = 0.92）、5年疾病特异性生存率（91%对93%，p = 0.54）和5年总生存率（78%对84%，p = 0.18）无差异。
结论
CO-TOLMS是女性喉癌的一种有效治疗方法，其结局与男性人群相当。
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