部分喉切除术作为T1-T2期喉癌放疗失败后的挽救性手术。
Partial laryngectomy as salvage surgery for radiation failures in T1-T2 laryngeal cancer.
作者信息
Rodríguez-Cuevas S, Labastida S, Gonzalez D, Briseño N, Cortes H
机构信息
Department of Surgery of Head & Neck Tumors, Hospital de Oncología, CMN, IMSS, México City, Rebsamen, México, DF.
出版信息
Head Neck. 1998 Oct;20(7):630-3. doi: 10.1002/(sici)1097-0347(199810)20:7<630::aid-hed9>3.0.co;2-k.
BACKGROUND
Radiotherapy is the treatment of choice for early glottic carcinoma. Thirteen percent to 24% of patients require salvage surgery. To evaluate time of recurrence, site, and locoregional control, we retrospectively reviewed 29 patients treated from 1981 to 1996.
METHODS
There were 28 men and 1 woman. Mean age was 63 years. Twenty were T1 (69%) and 9 were T2 (31%). Median time of recurrence was 14.5 months. In 14 patients (52%), a partial laryngectomy was done, and 13 patients had a total laryngectomy. Two refused surgery.
RESULTS
One patient relapsed after salvage surgery. Five-year survival after salvage surgery was 92%, with no difference between partial and total laryngectomy (p = 0.2).
CONCLUSIONS
Recurrences after failure to radiotherapy in T1-T2 glottic carcinoma could be salvaged with partial laryngectomy in 52% of patients, preserving laryngeal function, with adequate tumor control and acceptable morbidity. The selection of the surgical procedure is based on the tumor extension.
背景
放射治疗是早期声门癌的首选治疗方法。13%至24%的患者需要挽救性手术。为了评估复发时间、部位和局部区域控制情况，我们回顾性分析了1981年至1996年间接受治疗的29例患者。
方法
28例男性，1例女性。平均年龄63岁。20例为T1期（69%），9例为T2期（31%）。复发的中位时间为14.5个月。14例患者（52%）接受了部分喉切除术，13例患者接受了全喉切除术。2例拒绝手术。
结果
1例患者在挽救性手术后复发。挽救性手术后的5年生存率为92%，部分喉切除术和全喉切除术之间无差异（p = 0.2）。
结论
T1-T2期声门癌放疗失败后的复发患者，52%可通过部分喉切除术挽救，保留喉功能，肿瘤得到充分控制，发病率可接受。手术方式的选择基于肿瘤的扩展情况。
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