近全喉切除术治疗晚期喉癌。
Near-total laryngectomy for treatment of advanced laryngeal cancer.
作者信息
Lima R A, Freitas E Q, Kligerman J, Paiva F P, Dias F L, Barbosa M M, Sa G M, Soares J R
机构信息
Head and Neck Service, Hospital do Cancer, National Cancer Institute/INCA, Rio de Janeiro, Brazil.
出版信息
Am J Surg. 1997 Nov;174(5):490-1. doi: 10.1016/s0002-9610(97)00155-4.
BACKGROUND
In order to assess whether near-total laryngectomy (NTL) could successfully reach the cure and preserve the voice in advanced laryngeal cancer, we studied 28 patients with T3/T4 squamous cell carcinoma of the larynx treated with NTL in our institution.
METHODS
A retrospective analysis has been carried out from 1990 through 1994. We classified 24 patients as Stage III and 4 patients as Stage IV. All patients had lateral neck dissection. Survival was analyzed under the Kaplan-Meier method.
RESULTS
Twenty-six patients achieved voice preservation. Two patients in the bilateral neck dissection group had a metastatic lymph node on the opposite side. No patient had local recurrence. Three patients died of the disease, and 1 patient was salvaged with neck dissection. Three-year disease-free survival was 85%.
CONCLUSION
This technique is useful in the treatment of selected cases of advanced laryngeal cancer and achieves local control of the lesion in all cases. The survival is comparable with that of patients submitted to total laryngectomy, regarding the extent of lesion. Voice preservation can be achieved in most cases.
背景
为了评估近全喉切除术（NTL）能否成功治愈晚期喉癌并保留嗓音，我们对本机构中28例接受NTL治疗的T3/T4期喉鳞状细胞癌患者进行了研究。
方法
对1990年至1994年的病例进行回顾性分析。我们将24例患者归类为III期，4例患者归类为IV期。所有患者均接受了侧颈清扫术。采用Kaplan-Meier法分析生存率。
结果
26例患者实现了嗓音保留。双侧颈清扫组中有2例患者对侧出现转移性淋巴结。无患者出现局部复发。3例患者死于该疾病，1例患者通过颈清扫术挽救。三年无病生存率为85%。
结论
该技术对部分晚期喉癌病例的治疗有用，且在所有病例中均实现了病变的局部控制。就病变范围而言，其生存率与接受全喉切除术的患者相当。大多数情况下可实现嗓音保留。
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