Lefebvre J L, Buisset E, Coche-Dequeant B, Van J T, Prevost B, Hecquet B, Demaille A
Head and Neck Department, Centre Oscar Lambret, Lille, France.
Head Neck. 1995 Sep-Oct;17(5):377-81. doi: 10.1002/hed.2880170503.
As a general rule, epilarynx is studied as a part of supraglottis. On the contrary, in France, due to its particular natural history, it is often studied separately.
To assess the value of this French classification, we compared from an epidemiologic point of view, in one study, 86 cases of epilarynx squamous cell carcinoma (SCC) with 431 oropharynx, 339 hypopharynx, and 89 vestibule SCC. In another study, we compared, from a clinical point of view, 232 epilarynx SCC with 1351 oropharynx, 652 hypopharynx, and 372 vestibule SCC.
Epilarynx patients appeared to be much heavier drinkers than larynx patients and similar to pharynx patients but tobacco consumption did not differ. The patterns of nodal involvement were similar for pharynx and epilarynx SCC. For stages I and II, patterns of failures were similar, but for stages III and IV, there were fewer locoregional failures in vestibule patients; distant metastases were equally frequent for these tumors. From the standpoint of multiple primaries, epilarynx SCC appeared to be more akin to pharynx than to larynx SCC with a much lower incidence of lung cancers. Finally, the outcome after treatment was different for vestibule, epilarynx, and pharynx SCC, with a 5-year survival of 43%, 27%, and 13%, respectively.
These data support the identification of epilarynx as a real entity that should be taken into account for stratification in clinical trials.
一般而言，喉上部被作为声门上区的一部分进行研究。相反，在法国，由于其特殊的自然病史，它常被单独研究。
为评估这种法国分类法的价值，在一项研究中，我们从流行病学角度比较了86例喉上部鳞状细胞癌（SCC）与431例口咽、339例下咽和89例前庭SCC。在另一项研究中，我们从临床角度比较了232例喉上部SCC与1351例口咽、652例下咽和372例前庭SCC。
喉上部患者似乎比喉部患者饮酒量更大，与咽部患者相似，但烟草消费量无差异。口咽和喉上部SCC的淋巴结受累模式相似。对于I期和II期，失败模式相似，但对于III期和IV期，前庭患者的局部区域失败较少；这些肿瘤的远处转移同样常见。从多原发肿瘤的角度来看，喉上部SCC似乎更类似于咽部而非喉部SCC，肺癌发病率低得多。最后，前庭、喉上部和咽部SCC的治疗后结果不同，5年生存率分别为43%、27%和13%。
这些数据支持将喉上部确定为一个实际的实体，在临床试验分层时应予以考虑。
