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Abstract：
BACKGROUND: For recurrent laryngeal cancer, the feasibility of salvage transoral laser microsurgery (TLM) remains controversial. This study compared the efficacy of TLM and open partial laryngectomy (OPL) for treatment of early local recurrence of glottic squamous cell cancer (GSCC) and confirm the effectiveness of salvage TLM as a treatment option.
METHODS: This retrospective study involved 55 patients with early local recurrent GSCC treated with TLM, and the oncologic outcomes, functional outcomes, hospitalization time and complications were compared with a group of 40 recurrent GSCC patients matched for clinical variables of TLM group, treated by OPL by the same team of surgeons.
RESULTS: The 5-year overall survival and disease-specific survival rates were 65.8% and 91.5%, respectively, for 55 patients with rTis-rT2 stage treated by TLM and 77.1% and 94.7%, respectively, for 40 patients with rTis-rT2 stage treated by OPL (OPL group). In the TLM and OPL groups, the local control rates after 5 years were 77.5% and 79.3%, respectively, and the laryngeal preservation rates were 94.4% and 83.6%, respectively (p > 0.05). Compared with the OPL group, the complication rate (1.82%) and hospitalization duration (5.42 ± 2.26 days) were significantly lower in the TLM group (p < 0.05). Compared with the OPL group, postsurgical health-related quality of life and quality of voice were significantly better in the TLM group (p < 0.001).
CONCLUSIONS: Salvage TLM can be used as an effective treatment option for suitable patients after a full, comprehensive, and careful assessment of the characteristics of early locally recurrent glottic carcinoma.
METHODS: This retrospective study involved 55 patients with early local recurrent GSCC treated with TLM, and the oncologic outcomes, functional outcomes, hospitalization time and complications were compared with a group of 40 recurrent GSCC patients matched for clinical variables of TLM group, treated by OPL by the same team of surgeons.
RESULTS: The 5-year overall survival and disease-specific survival rates were 65.8% and 91.5%, respectively, for 55 patients with rTis-rT2 stage treated by TLM and 77.1% and 94.7%, respectively, for 40 patients with rTis-rT2 stage treated by OPL (OPL group). In the TLM and OPL groups, the local control rates after 5 years were 77.5% and 79.3%, respectively, and the laryngeal preservation rates were 94.4% and 83.6%, respectively (p > 0.05). Compared with the OPL group, the complication rate (1.82%) and hospitalization duration (5.42 ± 2.26 days) were significantly lower in the TLM group (p < 0.05). Compared with the OPL group, postsurgical health-related quality of life and quality of voice were significantly better in the TLM group (p < 0.001).
CONCLUSIONS: Salvage TLM can be used as an effective treatment option for suitable patients after a full, comprehensive, and careful assessment of the characteristics of early locally recurrent glottic carcinoma.
摘要：
背景：对于复发性喉癌，经口激光显微手术(TLM)的可行性仍存在争议.本研究比较了TLM和开放喉部分切除术（OPL）治疗声门鳞状细胞癌（GSCC）早期局部复发的疗效，并证实了挽救性TLM作为治疗选择的有效性。
方法：本回顾性研究纳入55例早期局部复发GSCC患者，和肿瘤的结果，功能结果，将住院时间和并发症与TLM组的40例复发GSCC患者进行比较,由OPL由同一外科医生团队治疗。
结果：5年总生存率和疾病特异性生存率分别为65.8％和91.5％，分别,对于55例接受TLM治疗的rTis-rT2期患者，分别为77.1%和94.7%，分别,对于40例接受OPL治疗的rTis-rT2期患者（OPL组）。在TLM和OPL组中，5年后的局部控制率分别为77.5%和79.3%，分别,喉保存率分别为94.4%和83.6%,分别为(p>0.05)。与OPL组相比,TLM组的并发症发生率（1.82%）和住院时间（5.42±2.26天）明显低于TLM组（p<0.05）。与OPL组相比,TLM组术后健康相关生活质量和嗓音质量显著改善(p<0.001).
结论：打捞TLM可以作为一种有效的治疗选择，适合患者经过充分的治疗，全面,并仔细评估早期局部复发性声门癌的特征。
方法：本回顾性研究纳入55例早期局部复发GSCC患者，和肿瘤的结果，功能结果，将住院时间和并发症与TLM组的40例复发GSCC患者进行比较,由OPL由同一外科医生团队治疗。
结果：5年总生存率和疾病特异性生存率分别为65.8％和91.5％，分别,对于55例接受TLM治疗的rTis-rT2期患者，分别为77.1%和94.7%，分别,对于40例接受OPL治疗的rTis-rT2期患者（OPL组）。在TLM和OPL组中，5年后的局部控制率分别为77.5%和79.3%，分别,喉保存率分别为94.4%和83.6%,分别为(p>0.05)。与OPL组相比,TLM组的并发症发生率（1.82%）和住院时间（5.42±2.26天）明显低于TLM组（p<0.05）。与OPL组相比,TLM组术后健康相关生活质量和嗓音质量显著改善(p<0.001).
结论：打捞TLM可以作为一种有效的治疗选择，适合患者经过充分的治疗，全面,并仔细评估早期局部复发性声门癌的特征。
