Yuen A P, Wei W I, Hui Y, Ho W K
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
Am J Otolaryngol. 1996 Nov-Dec;17(6):380-5. doi: 10.1016/s0196-0709(96)90070-8.
This study analyzes the incidence, risk factors, treatment results, and prognosis of local recurrence at the pharynx after total laryngectomy for laryngeal carcinoma.
The records of 292 patients who underwent total laryngectomy for the treatment of laryngeal carcinoma between January 1978 and December 1990 were reviewed.
Of these 292 patients, there were 24 patients who developed local recurrence at the pharynx. The 5-year actuarial cumulative local recurrence rate was 10%. There were 17 cases of pharyngeal recurrence alone, five cases of pharyngeal and nodal recurrence, one case of pharyngeal and tracheostomal recurrence, and one case of pharyngeal and distant metastasis. Ten (42%) patients were salvaged surgically; the 5-year actuarial survival rate after surgical salvage was 53%. The other 14 patients were treated with palliative treatment, and all died of tumor, with the longest period of survival being 28 months.
Surgical salvage of pharyngeal recurrence has acceptable results. Close monitoring of patients is important to have an early diagnosis of salvageable recurrence.
本研究分析喉癌全喉切除术后咽局部复发的发生率、危险因素、治疗结果及预后。
回顾了1978年1月至1990年12月期间接受全喉切除术治疗喉癌的292例患者的记录。
在这292例患者中，有24例发生咽局部复发。5年精算累积局部复发率为10%。单纯咽复发17例，咽和淋巴结复发5例，咽和气管造口复发1例，咽和远处转移1例。10例（42%）患者经手术挽救；手术挽救后的5年精算生存率为53%。其他14例患者接受姑息治疗，均死于肿瘤，最长生存期为28个月。
咽复发的手术挽救有可接受的结果。密切监测患者对于早期诊断可挽救的复发很重要。
