Oncological and functional outcomes of transoral laser surgery for laryngeal carcinoma
Oncological and functional outcomes of transoral laser surgery for laryngeal carcinoma
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DOI：
10.1007/s00405-018-5027-z
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发表时间：
2018-08-01
影响因子：
2.6
通讯作者：
Pablo Rodrigo, Juan
中科院分区：
文献类型：
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作者：
Pedregal-Mallo, Daniel;Sanchez Canteli, Mario;Pablo Rodrigo, Juan
经口激光显微手术（TLM）由于其良好的肿瘤学和功能结果，局部并发症少，已成为大多数机构治疗早期喉癌的标准方法。为分析TLM在喉肿瘤治疗中的肿瘤学和功能结果，回顾了我院1998年至2013年接受TLM治疗的喉鳞状细胞癌（LSCC）患者，随访时间至少为24个月。195例患者为男性（96%）和8例女性（4%），平均年龄为63岁。该系列包括134（66%）T1，40（20%）T2和29（14%）T3分类肿瘤。声门116例（57%），声门上79例（39%），前连合8例（4%）。16例（8%）患者接受了辅助放疗。75.5%的患者获得了初始局部控制。5年总生存率为84%，5年疾病特异性生存率为90%。多变量分析显示，淋巴结转移（p < 0.001）和手术切缘受累（p = 0.004）与较低的疾病特异性生存率相关。除了3名局部控制疾病的患者外，所有患者均恢复口服饮食，无气管切开依赖者。TLM是治疗早中晚期喉癌的一种微创治疗方法，具有良好的肿瘤学和功能结局，并发症少。
Transoral laser microsurgery (TLM) has become the standard approach for treatment of early-stage laryngeal carcinoma in most institutions due to their good oncological and functional results with few local complications. The purpose of this study was to analyze the oncological and functional results of TLM in the treatment of laryngeal tumors at our Hospital.Patients with laryngeal squamous cell carcinoma (LSCC) treated from 1998 to 2013 with TLM with curative intention, and with a minimum follow-up of 24 months, were reviewed.203 patients with LSCC were included. 195 patients were men (96%) and 8 women (4%), with a mean age of 63 years. The series includes 134 (66%) T1, 40 (20%) T2, and 29 (14%) T3-classified tumors. 116 tumors (57%) were in the glottis, 79 (39%) in the supraglottis and 8 (4%) in the anterior commissure. 16 patients (8%) received adjuvant radiotherapy. Initial local control was obtained in 75.5% of patients. The 5-year overall survival rate was 84% and the 5-year disease-specific survival was 90%. The presence of nodal metastasis (p < 0.001) and the involvement of the surgical margins (p = 0.004) were associated with a lower disease-specific survival in the multivariate analysis. All but three patients with local control of the disease reassumed oral diet, and none were tracheostomy-dependent. The 5-year laryngeal preservation rate was 85%.TLM is a minimally invasive treatment for early and moderately-advanced laryngeal carcinomas, with good oncologic and functional outcomes, and few complications as well.