Carbon dioxide laser microsurgery for early supraglottic carcinoma
Carbon dioxide laser microsurgery for early supraglottic carcinoma
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DOI：
10.1177/000348949810700810
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发表时间：
1998-08-01
影响因子：
1.4
通讯作者：
Steiner, W
中科院分区：
文献类型：
--
作者：
Ambrosch, P;Kron, M;Steiner, W
1979年至1994年间，48例未经治疗的早期声门上癌患者（12例I期患者和36例II期患者）接受了初次二氧化碳激光显微手术，目的是完全切除肿瘤，保留喉的重要功能结构。96%的患者仅接受手术治疗; 4%的患者接受激光显微手术和术后放疗。中位随访时间为55个月，pT 1病例首次治疗的5年局部控制率为100%，pT 2病例为89%。保留声音的最终局部控制率，包括局部复发后成功挽救的患者，pT 2癌为97%。5例（10%）患者死于肿瘤（TNM）相关死亡。3年无复发率和3年总生存率（Kaplan-Meier）分别为87%和85%; 5年无复发率和5年总生存率分别为83%和76%。在局部控制和生存率方面，经口激光显微手术治疗早期声门上癌的结果与开放式声门上喉切除术相当。功能结果是上级的。因为没有发生临床相关抽吸。
Forty-eight untreated patients with early supraglottic carcinoma (12 patients stage I and 36 patients stage II) had primary carbon dioxide laser microsurgery between 1979 and 1994 with the intent of complete tumor removal with preservation of functionally important structures of the larynx. Ninety-six percent of the patients were treated exclusively by surgery; 4% had laser microsurgery and postoperative radiotherapy. With a median follow-up of 55 months, the 5-year local control rate with the first treatment was 100% for pT1 cases and 89% for pT2 cases. The ultimate local control rate with voice preservation, including patients successfully salvaged after a local recurrence, was 97% for pT2 carcinomas. Five (10%) patients died of tumor (TNM)-related deaths. The 3-year recurrence-free rate and 3-year overall survival rate (Kaplan-Meier) were 87% and 85%; the 5-year recurrence-free rate and 5-year overall survival rate were 83% and 76%, respectively. The results achieved with transoral laser microsurgery in early supraglottic carcinoma are comparable to those of open supraglottic laryngectomy with respect to local control and survival. The functional results are superior. since clinically relevant aspiration did not occur.