背景:在一个临床中心使用综合分析的经口激光显微手术(TLM)和开放式喉部分切除术(OPL)之间的肿瘤学结果很少见。这项研究的目的是评估TLM在早期声门癌患者中的肿瘤学结果。并将结果与OPL进行比较。
方法:记录425例T1-T2期声门癌患者接受TLM治疗,垂直部分喉切除术(VPL),回顾性分析2005年至2010年期间的环眼附眼固定术(CHEP)。总生存期(OS),疾病特异性生存率(DSS),评估了这三种治疗方法的喉功能保留(LFP)。
结果:122例患者接受了TLM治疗。关于OPL,167例患者接受VPL,136例患者接受了CHEP。平均年龄为59.7岁,男性占所有病例的97.2%。OS,DSS,前连合(AC)受累的患者接受TLM的LFP发生率比没有AC受累的患者差,但这些差异没有统计学意义.5年OS,DSS,接受TLM的患者LFP为88.4%,89.9%,83.5%,分别,以及接受TLM的患者的肿瘤学结果,VPL,和CHEP没有统计学差异。
结论:使用TLM治疗的早期喉癌患者的肿瘤学结果令人满意。TLM的三种治疗方法在肿瘤学结果上没有令人信服的差异,VPL和CHEP,以及VPL和CHEP可以替代不适合接受TLM的患者。
BACKGROUND: The oncologic outcomes between transoral laser microsurgery (TLM) and open partial laryngectomy (OPL) using comprehensive analysis in one clinical center is rare. The purpose of this study was to evaluate the oncologic outcomes of TLM in patients with early stage glottic carcinoma, and to compare the results with OPL.
METHODS: Records of 425 glottic carcinoma patients with T1 - T2 stage treated with TLM, vertical partial laryngectomy (VPL), and cricohyoidoepiglottopexy (CHEP) from 2005 to 2010 were retrospectively analyzed. The overall survival (OS), disease-specific survival (DSS), and laryngeal function preservation (LFP) of these three treatments were assessed.
RESULTS: One hundred and twenty-two patients were treated with TLM. Regarding OPL, 167 patients underwent VPL, and 136 patients underwent CHEP. The mean age was 59.7 years, with men accounting for 97.2 % of all cases. The OS, DSS, and LFP rates of patients with anterior commissure (AC) involvement undergoing TLM were worse than those of patients without AC involvement, but these differences were not statistically significant. The 5-year OS, DSS, and LFP of patients undergoing TLM were 88.4 %, 89.9 %, and 83.5 %, respectively, and the oncologic outcomes of patients undergoing TLM, VPL, and CHEP were not statistically different.
CONCLUSIONS: Glottic carcinoma patients with early stage treated with TLM experience satisfactory oncologic outcomes. No compelling difference in oncologic outcomes among three treatments of TLM, VPL and CHEP, as well as VPL and CHEP can be alternatives to patients who are not suitable for receiving TLM.