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Abstract：
OBJECTIVE: To analyze oncological and functional results of transoral minimally invasive surgery (TMIS) for supraglottic laryngeal carcinoma (SGLC), and investigate independent prognostic factors.
METHODS: Seventy SGLC patients treated with TMIS were included. The overall survival (OS), recurrence-free survival (RFS), and postoperative functions were analyzed.
RESULTS: Sixty-two patients were early-stage (Tis, T1, and T2) and eight patients were T3. Eleven patients received preoperative induction chemotherapy (IC). Sixty patients received transoral laser microsurgery (TLM), and 10 patients received transoral robotic surgery (TORS). Fifty-eight patients were scored Grade-1 by water swallow test, and 49 patients were scored Grade 0 by grade, roughness, breathiness, asthenia, strain. The 1, 3, and 5 year OS of all were 95.450%, 84.877%, and 78.026%, and RFS were 89.167%, 78.052%, and 75.451% respectively. Kaplan-Meier survival analysis showed N stage and clinical stage were associated with OS, smoking, clinical stage, surgical margins, and Ki-67 index were associated with RFS. There were no significant differences in preoperative IC or direct surgery, TLM, or TORS. Cox analyses showed smoking and surgical margins were independent prognosis factors for RFS.
CONCLUSIONS: The positive margin, Ki-67 index ≥40% and P53(+)&Ki-67 index ≥40% are worse factors affecting recurrence for SGLC patients. Both smoking and surgical margins are independent prognostic factors affecting recurrence.
METHODS: Seventy SGLC patients treated with TMIS were included. The overall survival (OS), recurrence-free survival (RFS), and postoperative functions were analyzed.
RESULTS: Sixty-two patients were early-stage (Tis, T1, and T2) and eight patients were T3. Eleven patients received preoperative induction chemotherapy (IC). Sixty patients received transoral laser microsurgery (TLM), and 10 patients received transoral robotic surgery (TORS). Fifty-eight patients were scored Grade-1 by water swallow test, and 49 patients were scored Grade 0 by grade, roughness, breathiness, asthenia, strain. The 1, 3, and 5 year OS of all were 95.450%, 84.877%, and 78.026%, and RFS were 89.167%, 78.052%, and 75.451% respectively. Kaplan-Meier survival analysis showed N stage and clinical stage were associated with OS, smoking, clinical stage, surgical margins, and Ki-67 index were associated with RFS. There were no significant differences in preoperative IC or direct surgery, TLM, or TORS. Cox analyses showed smoking and surgical margins were independent prognosis factors for RFS.
CONCLUSIONS: The positive margin, Ki-67 index ≥40% and P53(+)&Ki-67 index ≥40% are worse factors affecting recurrence for SGLC patients. Both smoking and surgical margins are independent prognostic factors affecting recurrence.
摘要：
目的：分析经口微创手术（TMIS）治疗声门上喉癌（SGLC）的肿瘤和功能结果，并探讨独立的预后因素。
方法：纳入接受TMIS治疗的70例SGLC患者。总生存期（OS），无复发生存率（RFS），并对术后功能进行分析。
结果：62例患者为早期阶段（Tis，T1和T2）和8例患者为T3。11例患者接受术前诱导化疗(IC)。60例患者接受经口激光显微手术（TLM），10例患者接受经口机器人手术(TORS).58名患者通过水吞咽测试获得1级评分，49例患者分0级，粗糙度,呼吸,虚弱,应变。1年、3年和5年OS均为95.450%,84.877%,和78.026%，RFS为89.167%，78.052%,和75.451%。Kaplan-Meier生存分析显示N分期和临床分期与OS相关,吸烟,临床分期,手术切缘,Ki-67指数与RFS相关。术前IC或直接手术无显著差异，TLM,或TORS。Cox分析显示，吸烟和手术切缘是RFS的独立预后因素。
结论：阳性边缘，Ki-67指数≥40％和P53（+）和Ki-67指数≥40％是SGLC患者复发的较差因素。吸烟和手术切缘是影响复发的独立预后因素。
方法：纳入接受TMIS治疗的70例SGLC患者。总生存期（OS），无复发生存率（RFS），并对术后功能进行分析。
结果：62例患者为早期阶段（Tis，T1和T2）和8例患者为T3。11例患者接受术前诱导化疗(IC)。60例患者接受经口激光显微手术（TLM），10例患者接受经口机器人手术(TORS).58名患者通过水吞咽测试获得1级评分，49例患者分0级，粗糙度,呼吸,虚弱,应变。1年、3年和5年OS均为95.450%,84.877%,和78.026%，RFS为89.167%，78.052%,和75.451%。Kaplan-Meier生存分析显示N分期和临床分期与OS相关,吸烟,临床分期,手术切缘,Ki-67指数与RFS相关。术前IC或直接手术无显著差异，TLM,或TORS。Cox分析显示，吸烟和手术切缘是RFS的独立预后因素。
结论：阳性边缘，Ki-67指数≥40％和P53（+）和Ki-67指数≥40％是SGLC患者复发的较差因素。吸烟和手术切缘是影响复发的独立预后因素。
