Survival outcomes in patients with T3-4aN0M0 glottic laryngeal squamous cell carcinoma and evaluation of postoperative radiotherapy.
Survival outcomes in patients with T3-4aN0M0 glottic laryngeal squamous cell carcinoma and evaluation of postoperative radiotherapy.
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DOI：
10.3892/ol.2022.13554
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发表时间：
2022-12
期刊：
影响因子：
2.9
通讯作者：
Tao L
中科院分区：
文献类型：
--
作者：
Zhou J;Heng Y;Yang Y;Zhu X;Zhou L;Gong H;Xu C;Tao L
本研究旨在评价喉切除术治疗T3-4aN0M0型声门喉癌（LSCC）患者的临床疗效，并从切缘阴性的T3-T4aN0M0患者的生存情况评估术后放疗（PORT）结果。这是对369例T3-4aN0M0声门LSCC的回顾性分析。5年肿瘤特异性生存率（CSS）和总生存率（OS）分别为67.5%和66.7%。接受全喉切除术的患者生存率较差[5年CSS， 62.5%；无病生存率（DFS, 56.2%）高于部分喉切除术患者（5年CSS， 79.3%； DFS, 65.4%）。更晚期的癌症预示着生存率较低。经抢救治疗的边缘阳性患者与边缘阴性患者的CSS和DFS无显著差异。此外，阴性切缘患者接受PORT治疗与未接受PORT治疗的生存率无差异（5年DFS: 59.1 vs. 63.8%， P=0.057; CSS: 62.5 vs. 69.5%， P=0.074）。对于T3-4aN0M0声门LSCC患者，手术治疗仍然是一个很好的选择，因为它可以获得满意的肿瘤预后。然而，PORT并没有增加手术治疗的p3 - 4an0m0切缘阴性LSCC患者的生存率。
This study aimed to evaluate the clinical outcomes of patients with T3-4aN0M0 glottic laryngeal squamous cell carcinoma (LSCC) treated with laryngectomy, and to assess the postoperative radiotherapy (PORT) results in terms of the survival of T3-T4aN0M0 patients with negative margins. This was a retrospective review of 369 T3-4aN0M0 glottic LSCC cases. The 5-year cancer-specific survival (CSS) and overall survival (OS) rates were 67.5 and 66.7%, respectively. Patients who received total laryngectomy had worse survival [5-year CSS, 62.5%; disease-free survival (DFS), 56.2%] than those who underwent partial laryngectomy (5-year CSS, 79.3%; DFS, 65.4%). More advanced-stage cancer is a predictor of poor survival. There was no significant difference in CSS or DFS between patients with positive margins following rescue therapy and those with negative margins. Furthermore, no difference in the survival rates was observed between patients with negative margins who received PORT and those who did not (5-year DFS: 59.1 vs. 63.8%, P=0.057 and CSS: 62.5 vs. 69.5%, P=0.074). For T3-4aN0M0 glottic LSCC patients, surgical treatment remained a good option, as it can achieve satisfactory oncological outcomes. However, PORT did not increase survival in surgically managed pT3-4aN0M0 LSCC patients with negative margins.
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