Partial laryngectomy to treat early glottic cancer after failure of radiation therapy
Partial laryngectomy to treat early glottic cancer after failure of radiation therapy
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DOI：
10.1001/archotol.128.8.909
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发表时间：
2002-08-01
影响因子：
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通讯作者：
Sugasawa, M
中科院分区：
文献类型：
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作者：
Toma, M;Nibu, K;Sugasawa, M
目的：评价喉部分切除术治疗放射治疗失败后声门癌的作用。设计：12 年回顾性结果分析地点：大学转诊中心。患者：共有 19 例放射治疗失败后接受部分喉切除术治疗声门癌的患者。结果：本组随访时间为 31 至 144 个月。术后出现喉皮瘘4例，皮瓣坏死2例，均得到成功处理。术后最大发声时间为 3 至 28 秒（中位发声时间为 10.2 秒）。在这19名患者中，3名出现局部复发。这些病例均通过全喉切除术成功治疗。研究发现，小于1毫米的手术切缘是部分喉切除术后局部复发的重要危险因素。结论：这些结果表明，部分喉切除术是治疗I期和11期声带癌照射失败的有效选择。然而，对于手术切缘较小的患者，必须进行仔细的随访。
Objective: To evaluate the role of partial laryngectomy to treat glottic cancer after failure of radiation therapy.Design: A 12-year retrospective outcome analysisSetting: University referral center.Patients: A total of 19 patients who underwent partial laryngectomy to treat glottic cancer after failure of radiation therapy.Results: The follow-up period in this group ranged from 31 to 144 months. After surgery, a laryngocutaneous fistula was observed in 4 cases, and flap necrosis occurred in 2, but these complications were successfully managed. Maximum phonation time after surgery ranged from 3 to 28 seconds (median phonation time, 10.2 seconds). Of these 19 patients, 3 developed local recurrence. These cases were successfully treated with total laryngectomy. A surgical margin of less than 1 mm was found to be a significant risk factor for local recurrence after partial laryngectomy.Conclusions: These results indicate that partial laryngectomy is a useful option for the treatment of irradiation failure in the treatment of stage I and stage 11 vocal cord carcinomas. However, careful follow-up is mandatory for patients with a small surgical margin.