One hundred supracricoid laryngectomies with cricohyoidoepiglottopexy: do we achieve better local control?
One hundred supracricoid laryngectomies with cricohyoidoepiglottopexy: do we achieve better local control?
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一百例环甲会厌固定术的环上喉切除术：我们能否实现更好的局部控制？
DOI：
10.1093/jjco/hyv072
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发表时间：
2015
期刊：
影响因子：
2.4
通讯作者：
Okamoto M
中科院分区：
文献类型：
--
作者：
Nakayama M;Miyamoto S;Seino Y;Okamoto T;Kano K;Hasebe M;Okamoto M
环软骨上喉切除术和环舌骨会厌固定术被认为能够科普肿瘤切除的最小边缘。扩大切除可能导致边缘受限，并可能影响预后。我们进行了一项临床病理分析，局部复发的环状软骨上喉切除术与环舌骨会厌固定patients.MethodsBetween 1997年和2013年，100例声门癌患者进行了环状软骨上喉切除术与环舌骨会厌固定。对临床病理结果进行评价。我们还分析了：（一）癌症的特异性和总体生存率，（二）局部复发和总体生存之间的相关性，（三）T分期和喉保存率和（四）以前的放射史和喉preservation rates.ResultsLocal复发被确认在8个100例（8%），所有最初分期为T3或T4。在同侧杓状软骨和/或声门下的粘膜下区域发现复发。除2例外，其余6例均行全喉切除术。5年癌症特异性生存率为93%; 5年总生存率为89%。总生存率和局部复发率之间无显著差异。T1-2和T3-4患者保留喉功能的差异有统计学意义。喉的保存和以前的放射治疗status.ConclusionsOur经验之间没有显着差异，我们相信我们的临床潜力的环上软骨喉切除术与环舌骨肌epiglottopesis作为一个有效的选择功能喉保存。环状软骨上喉切除术联合环舌骨会厌固定术最适合T2和T3 a不良病例，也适用于适当选择的放射失败患者。充分的术前评估、正确的手术技巧和仔细的随访是成功的先决条件。
ObjectiveSupracricoid laryngectomy with cricohyoidoepiglottopexy has been known to be able to cope with tumor excisions with minimal margins. Extended resection may result in a limited margin and may impair the prognosis. We conducted a clinicopathologic analysis of local recurrence in supracricoid laryngectomy with cricohyoidoepiglottopexy patients.MethodsBetween 1997 and 2013, 100 patients with glottic cancers underwent supracricoid laryngectomy with cricohyoidoepiglottopexy. The clinicopathologic findings were evaluated. We also analyzed: (i) cancer-specific and overall survival rates, (ii) the correlation between locoregional recurrence and overall survival, (iii) T staging and larynx preservation rates and (iv) previous radiation history and larynx preservation rates.ResultsLocal recurrence was recognized in eight of the 100 patients (8%); all were initially staged as T3 or T4. Recurrence was identified in the submucosal regions of the ipsilateral arytenoid and/or infraglottis. Six patients were salvaged by completion total laryngectomy except two. Cancer-specific survival at 5 years was 93%; overall survival at 5 years was 89%. There was no significant difference between overall survival and locoregional recurrence. There was a significant difference between larynx preservation in T1–2 and T3–4 patients. There was no significant difference between larynx preservation and the previous radiation therapy status.ConclusionsOur experience convinced us of the clinical potential of supracricoid laryngectomy with cricohyoidoepiglottopexy as one of the effective options for functional larynx preservation. Supracricoid laryngectomy with cricohyoidoepiglottopexy is the most suitable for unfavorable T2 and T3a cases and is applicable for appropriately selected radiation-failed patients. Thorough pre-operative evaluation, proper surgical techniques and careful follow-up are prerequisites for the success of supracricoid laryngectomy with cricohyoidoepiglottopexy.