Rocha Daniel Abreu, de Alvarenga Gustavo Fernandes, Ramos Daniel Marin, de Matos Leandro Luongo, Dedivitis Rogerio Aparecido, Kulcsar Marco Aurélio Vamondes, Cernea Claudio Roberto
Universidade de São Paulo (USP), Faculdade de Medicina (FM), Hospital das Clínicas (HC), São Paulo, SP, Brazil.
Universidade de São Paulo (USP), Faculdade de Medicina (FM), Hospital das Clínicas (HC), São Paulo, SP, Brazil.
Braz J Otorhinolaryngol. 2025 Jul;91 Suppl 1(Suppl 1):101614. doi: 10.1016/j.bjorl.2025.101614. Epub 2025 May 29.
Evaluate the oncological and functional outcomes of patients submitted to HPL for the treatment of LSCC.
A retrospective descriptive study of patients submitted to HPL, performed at a cancer referral center, between January 2011 and December 2017.
We evaluated 37 patients. The major pathological staging of the primary tumor was pT3 (35.1%), followed by pT2 (32.4%). Five patients required adjuvant radiotherapy; 62.2% of the patients were decannulated by the end of the treatment; 10.8% weren't decannulated; 8.1% underwent a retracheostomy, and 18.9% had total laryngectomy. From the patients submitted to total laryngectomy, 3 cases were due to rehabilitation failure, 2 due to recurrence and 2 cases due to postoperative suture dehiscence. About 89% of the patients resumed oral feeding following the procedure; 86.4% didn't present disease recurrence; 31 patients survived without disease; 3 died from disease-related causes, and 3 from unrelated causes.
HPL is an alternative procedure to total laryngectomy, presenting adequate rates of local control and overall survival while also maintaining laryngeal function. The main challenge to HPL remains achieving an ideal selection of patients.
Level IV.
评估接受保留喉功能手术（HPL）治疗喉鳞状细胞癌（LSCC）患者的肿瘤学和功能结局。
对2011年1月至2017年12月期间在癌症转诊中心接受HPL治疗的患者进行回顾性描述性研究。
我们评估了37例患者。原发肿瘤的主要病理分期为pT3（35.1%），其次是pT2（32.4%）。5例患者需要辅助放疗；62.2%的患者在治疗结束时拔管；10.8%的患者未拔管；8.1%的患者进行了再次气管切开术，18.9%的患者进行了全喉切除术。在接受全喉切除术的患者中，3例是由于康复失败，2例是由于复发，2例是由于术后缝线裂开。约89%的患者术后恢复经口进食；86.4%的患者未出现疾病复发；31例患者无病存活；3例死于与疾病相关的原因，3例死于无关原因。
HPL是全喉切除术的一种替代手术，在保持喉功能的同时，具有足够的局部控制率和总生存率。HPL的主要挑战仍然是实现对患者的理想选择。
IV级。
