一项关于早期声门癌垂直部分喉切除术与经口激光显微手术的肿瘤学结局、功能结果及喉保留情况的系统评价。
A systematic review on oncological outcomes, functional results, and laryngeal preservation in vertical partial laryngectomies vs. transoral laser microsurgery for early stage glottic cancer.
作者信息
Bassani Sara, Dedivitis Rogerio Aparecido, Molteni Gabriele, Zampieri Erica, Dalmazzini Cecilia, de Castro Mario Augusto Ferrari, Kowalski Luiz Paulo
机构信息
Otolaryngology-Head and Neck Surgery Department, University of Verona, Piazzale L.A. Scuro, 10, Verona, 37134, Italy.
Department of Head and Neck Surgery, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
出版信息
Eur Arch Otorhinolaryngol. 2025 Sep 3. doi: 10.1007/s00405-025-09657-6.
PURPOSE
To compare the oncological and functional outcomes of transorallaser microsurgery (TLM) and vertical partial laryngectomy (VPL) in earlystageglottic carcinoma (T1-T2).
METHODS
A systematic review following PRISMA guidelines analyzedcomparative studies from 2000 to 2024 in PubMed, EMBASE, and Web ofScience. Outcomes included local control, recurrence rates, larynxpreservation, survival, voice quality, and complications.
RESULTS
Eight studies met inclusion criteria. TLM and VPL showed comparablesurvival rates for T1 tumors, but VPL provided better local control and larynxpreservation in T2 and anterior commissure involvement cases. TLM had higherrecurrence risk but superior functional outcomes, including better voicepreservation, shorter hospital stays, and lower complication rates.
CONCLUSION
Both techniques are viable, but TLM is preferred for T1 tumors,while VPL should be considered for T2 lesions because of higher local controlrates. Patient priorities and tumor characteristics should guide surgical choice.
目的
比较经口激光显微手术（TLM）和垂直部分喉切除术（VPL）治疗早期声门癌（T1-T2）的肿瘤学和功能学结果。
方法
按照PRISMA指南进行系统评价，分析了2000年至2024年在PubMed、EMBASE和科学网中发表的比较研究。结果包括局部控制、复发率、喉保留、生存率、语音质量和并发症。
结果
八项研究符合纳入标准。对于T1期肿瘤，TLM和VPL的生存率相当，但在T2期以及累及前联合的病例中，VPL能提供更好的局部控制和喉保留效果。TLM复发风险较高，但功能学结果更佳，包括更好的嗓音保留、更短的住院时间和更低的并发症发生率。
结论
两种技术都是可行的，但对于T1期肿瘤，TLM是首选；由于局部控制率较高，对于T2期病变应考虑VPL。患者的优先需求和肿瘤特征应指导手术选择。
Zotero 插件