背景:可切除喉癌的主要治愈性治疗包括手术和放化疗。其他治疗方案包括放疗,放化疗,喉部分切除术,和全喉切除术.喉保留治疗(喉部分切除术,放射治疗,和放化疗)建议在早期病例中,尽管在晚期病例中需要全喉切除术。这里,我们评估了治疗策略的趋势,并确定了决策中重要的因素.
方法:我们对日本的电子病历数据进行了回顾性分析。我们的分析包括2014年1月至2018年12月期间收治的住院喉癌患者。主要结果是初始治疗。
结果:共有363名患者(平均年龄71.8±9.5,男/女=333/30)符合纳入标准。其中,10.1%的患者接受全喉切除术治疗,而17.9%的人接受了部分切除,65.8%接受放疗(放化疗),6.1%没有治疗。大多数T1-2例(96.9%)采用保留喉治疗,40%的T3癌患者接受全喉切除术(校正比值比26.7[95%CI,9.29-91.6]).在接受治疗的T3癌症中,只有26.7%的≤65岁患者进行了全喉切除术,但超过50%的年龄>65岁。
结论:这项回顾性研究表明,在大多数T1-2病例中使用了保留喉的治疗方法,提示T分期是影响喉癌治疗决策的最重要因素。患有T3疾病的老年患者倾向于接受全喉切除术,年龄是T3喉癌病例决策过程中的重要因素。
BACKGROUND: Primary curative treatment of resectable laryngeal cancer includes surgery and chemoradiotherapy. Other treatment options include radiotherapy, chemoradiotherapy, partial
laryngectomy, and total
laryngectomy. Larynx-preserving treatments (partial
laryngectomy, radiotherapy, and chemoradiotherapy) are recommended in early stage cases, although total
laryngectomy is needed in advanced cases. Here, we evaluated trends in treatment strategies and identified the factors that are important in decision making.
METHODS: We performed a retrospective analysis of data acquired from electronic medical records in Japan. Hospitalized laryngeal cancer patients admitted between January 2014 and December 2018 were included in our analyses. The primary outcome was the initial treatment.
RESULTS: A total of 363 patients (mean age 71.8 ± 9.5, male/female = 333/30) met the inclusion criteria. Of these, 10.1% of the patients were treated with total laryngectomy, while 17.9% underwent partial resection, 65.8% received radiotherapy (chemoradiotherapy), and 6.1% had no treatment. Larynx-preserving treatment was used in most T1-2 cases (96.9%), and 40% of the patients with T3 cancer underwent total laryngectomy (adjusted odds ratio 26.7 [95% CI, 9.29-91.6]). Of the T3 cancers that were treated, total
laryngectomy was performed in only 26.7% of patients aged ≤65 years, but in more than 50% of those aged >65 years.
CONCLUSIONS: This retrospective
study showed that larynx-preserving treatments were used in most T1-2 cases, and suggested that T stage is the most important factor affecting decision making in the treatment of laryngeal cancer. Older patients with T3 disease tended to undergo total laryngectomy, and age is an important factor in the decision-making process for cases of T3 laryngeal cancer.