Endoscopic treatment of cT2 glottic carcinoma: Prognostic impact of different pT subcategories
Endoscopic treatment of cT2 glottic carcinoma: Prognostic impact of different pT subcategories
复制标题
DOI：
10.1177/000348940511400801
复制
发表时间：
2005-08-01
影响因子：
1.4
通讯作者：
Bolzoni, A
中科院分区：
文献类型：
--
作者：
Peretti, G;Piazza, C;Bolzoni, A
目的：cT 2声门型喉鳞状细胞癌是一组异质性的病变在浅表和深部的蔓延。因此，它们在治疗适应症和预后方面差异很大。本研究的目的是根据放射学和术后组织病理学信息将CT 2声门肿瘤分为亚类，以确定生存率，局部区域控制和喉preservationrates.Methods的危险因素：我们回顾性分析了55个CT 2声门病变治疗在一个单一的机构，二氧化碳激光至少2年的随访。回顾临床、影像学、手术和组织病理学资料，并将肿瘤分为5个亚类：I型或PT 2型伴声门上外侧侵犯（19例患者）; 11例，或pT 2伴声门下外侧伸展（6例患者）; III或pT 2伴连合上和/或连合下延伸（10例患者）; IV或pT 2伴深声带肌浸润（14名患者）; V或pT 3，用于术前CT扫描未检测到的甲杓肌外侧的上级和/或下声门旁间隙侵犯结果：比较了各亚类的无病生存率、单纯激光治疗的最终局部控制率和喉保留率。仅在pT 3亚组中发现了统计学显著差异（pT 3的2年发生率为16.7%、16.7%和16.7%，而整个pT 2组的5年发生率为80.5%、84.7%和93.3%）。结论：当pT 2分期得到证实时，cT 2声门肿瘤的内镜治疗可以被认为是有效的。在cT 2/pT 3患者中，在允许正确pT分期的首次内镜切除术后，应始终考虑额外治疗。
Objectives: The cT2 glottic squamous cell carcinomas are a heterogeneous group of lesions in terms of superficial and deep extension. As a consequence, they differ greatly in treatment indications and prognosis. The aim of the present study was to divide cT2 glottic tumors into subcategories according to radiologic and postoperative histopathologic information, in order to identify risk factors connected with determinate survival, local-regional control, and laryngeal preservation rates.Methods: We retrospectively analyzed 55 cT2 glottic lesions treated at a single institution by carbon dioxide laser with at least 2 years of follow-up. Clinical, radiologic, surgical, and histopathologic data were reviewed, and the tumors were accordingly divided into 5 subcategories: I, or pT2 with lateral supraglottic extension (19 patients); 11, or pT2 with lateral subglottic extension (6 patients); III, or pT2 with supracommissural and/or subcommissural extension (10 patients); IV, or pT2 with deep vocal muscle infiltration (14 patients); and V, or pT3, for superior and/or inferior paraglottic space invasion lateral to the thyroarytenoid muscle not detected before operation by computed tomographic scan (6 patients).Results: The disease-free survival, ultimate local control with laser alone, and laryngeal preservation rates were compared for each subcategory. Statistically significant differences were found only for the pT3 subgroup (2-year rates of 16.7%, 16.7%, and 16.7% for pT3 versus 5-year rates of 80.5%, 84.7%, and 93.3% for the entire pT2 group).Conclusions: Endoscopic treatment of cT2 glottic tumors can be considered effective when the pT2 stage has been confirmed. In cT2/pT3 patients, after the first endoscopic resection that allows the correct pT staging, additional treatment should always be considered.