METHODS: Twenty-nine OPHL patients whose pathological exam was consistent with pT4aN0-x disease were enrolled and their clinical charts were retrospectively reviewed. The study analyzed oncological outcomes, such as local, regional, and distant recurrence rates (RR), overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS). Additionally, functional results were analyzed, including decannulation rate, hospitalization time, and postoperative complication rate.
RESULTS: The study revealed and overall recurrence rate of 27%. The final rates for OS and DSS were 68% and 79%, respectively. Based on the univariate analysis the PTND was significantly associated with longer DFS. No significant differences inoncological outcomes were observed between pT4a patients who underwent adjuvant radio/radiochemotherapy and those who did not, in terms of RR, DFS, DSS or OS. However, adjuvant treatment was found to significantly increase decannulation time.
CONCLUSIONS: In a properly super-selected subgroup of patients with pT4aN0 LSCC, OPHL may beconsidered as a conservative surgical option even without adjuvant treatment. However, for optimal oncological outcomes, it is strongly recommended to consider a central compartment dissection in cases of hypoglottic and anterior extra-laryngeal tumor extension.
方法:纳入病理检查符合pT4aN0-x疾病的29例OPHL患者,并回顾性分析其临床表现。这项研究分析了肿瘤的结果,如当地,区域,和远处复发率(RR),总生存期(OS),无病生存率(DFS),和疾病特异性生存(DSS)。此外,对功能结果进行了分析,包括拔管率,住院时间,术后并发症发生率。
结果:研究显示总复发率为27%。OS和DSS的最终比率分别为68%和79%,分别。根据单变量分析,PTND与较长的DFS显着相关。在接受辅助放疗/放化疗的pT4a患者和未接受辅助放疗/放化疗的pT4a患者之间,肿瘤学结果没有显着差异,就RR而言,DFS,DSS或操作系统。然而,发现辅助治疗可显着增加拔管时间。
结论:在一个适当超选择的pT4aN0LSCC患者亚组中,即使没有辅助治疗,OPHL也可能被认为是保守的手术选择。然而,为了获得最佳的肿瘤结果,强烈建议在声门减退和喉外肿瘤前段扩展的情况下考虑中央室夹层。