Nibu K, Kamata S, Kawabata K, Nakamizo M, Nigauri T, Hoki K
Department of Otolaryngology, University of Tokyo, Japan.
Head Neck. 1997 Mar;19(2):116-20. doi: 10.1002/(sici)1097-0347(199703)19:2<116::aid-hed5>3.0.co;2-7.
This study was undertaken to analyze the functional results, complications, local control rates, and survival in patients undergoing conservation surgery for squamous cell carcinoma (SCC) of the larynx as a salvage procedure for recurrent tumors after previous radiotherapy.
Twenty-one patients underwent frontolateral laryngectomy for radiation failure, T1 and T2 glottic SCC, at the Cancer Institute Hospital, Tokyo, from 1976 to 1991. All patients were men between the ages of 42 and 83 years. The disease-free interval ranged from 1 to 87 months (median, 26 months). The stage at initial treatment was T1 in 17 patients and T2 in four patients. Local recurrence developed in three patients.
The rate of local control was influenced by a surgical margin of less than 1 mm (p < 0.05). Overall voice preservation was achieved in 86% of the patients. The 5-year and 10-year survival rates following frontolateral laryngectomy were 86% and 70%, respectively. Maximum phonation time after surgery ranged from 4 to 18 seconds (median, 8.1 seconds).
These results indicate that in carefully selected cases, frontolateral laryngectomy may be used for treating radiation failure stage I or II vocal cord carcinomas with good success. Careful follow-up may be necessary in patients with a close surgical margin.
本研究旨在分析接受喉鳞状细胞癌（SCC）保喉手术患者的功能结果、并发症、局部控制率及生存率，该手术作为先前放疗后复发性肿瘤的挽救性手术。
1976年至1991年期间，21例患者在东京癌症研究所医院因放疗失败、T1和T2声门型SCC接受了前外侧喉切除术。所有患者均为42至83岁的男性。无病间期为1至87个月（中位数为26个月）。初始治疗阶段，17例患者为T1期，4例患者为T2期。3例患者出现局部复发。
手术切缘小于1毫米会影响局部控制率（p < 0.05）。86%的患者实现了总体嗓音保留。前外侧喉切除术后的5年和10年生存率分别为86%和70%。术后最大发声时间为4至18秒（中位数为8.1秒）。
这些结果表明，在精心挑选的病例中，前外侧喉切除术可用于治疗放疗失败的I期或II期声带癌，且成功率较高。手术切缘接近的患者可能需要密切随访。
