Organ preservation by transoral laser microsurgery in piriform sinus carcinoma
Organ preservation by transoral laser microsurgery in piriform sinus carcinoma
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DOI：
10.1067/mhn.2001.111597
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发表时间：
2001-01-01
影响因子：
3.4
通讯作者：
Kron, M
中科院分区：
文献类型：
--
作者：
Steiner, W;Ambrosch, P;Kron, M
目的：为确定保留器官的CO2激光显微手术治疗梨状窝癌的有效性，方法：回顾性分析了1981年至1996年12月期间接受CO2激光显微手术治疗梨状窝鳞状细胞癌的129例未经治疗的患者。目的是通过保留喉的重要功能结构来完全切除肿瘤。肿瘤分布（国际抗癌联盟/美国癌症联合委员会，1992年）为pT 1型24例，pT 2型74例，pT 3型17例，pT 4型14例。68%的患者淋巴结状态为阳性，75%的患者为III或IV期疾病。42%的患者仅接受手术治疗，58%的患者接受手术和术后放疗。中位随访时间为44个月。颈部复发14.0%，异时性远处转移6.2%，第二原发灶18.6%。20%的患者死于TNM相关死亡。5年无复发生存率分别为95%和69%。结论：梨状窝癌保留喉功能的手术具有较低的局部复发率和较高的无复发生存率。
OBJECTIVE: To determine the effectiveness of organ-preserving CO(2) laser microsurgery for the treatment of piriform sinus carcinoma.METHODS: A retrospective review of 129 previously untreated patients undergoing CO(2) laser microsurgery for the treatment of squamous cell carcinomas of the piriform sinus from 1981 to December 1996 was undertaken. The intention was complete tumor removal by preserving functionally important structures of the larynx. Distribution of tumors (Union Internationale Contre le Cancer/American Joint Committee on Cancer, 1992) was 24 cases with pT1,74 with pT2, 17 with pT3, and 14 with pT4 disease. Node status was positive in 68% of patients, Seventy-five percent of patients had stage III or IV disease. Forty-two percent of the patients were treated solely with surgery, and 58% had surgery and postoperative radiotherapy The median follow-up interval was 44 months.RESULTS: Eighty-seven percent of patients were controlled locally. Neck recurrences occurred in 14.0% of patients, metachronous distant metastases with locoregional control in 6,2%, and second primary tumors in 18,6%, Twenty percent of patients died of TNM-related deaths, The 5-year overall Kaplan-Meier survival rate was 71% for stages I and II and 47% for stages III and IV disease; the 5-year recurrence-free survival rates were 95% and 69%, respectively.CONCLUSION: A comparatively low local recurrence rate, a high recurrence-free survival rate, and the avoidance of laryngectomy favor functionpreserving surgery of piriform sinus carcinomas.