Functional and Survival Outcomes in Patients Undergoing Total Glossectomy Compared with Total Laryngoglossectomy
Functional and Survival Outcomes in Patients Undergoing Total Glossectomy Compared with Total Laryngoglossectomy
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DOI：
10.1177/0194599811412724
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发表时间：
2011-11-01
影响因子：
3.4
通讯作者：
Rosenthal, Eben L.
中科院分区：
文献类型：
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作者：
Sinclair, Catherine F.;Carroll, William R.;Rosenthal, Eben L.
客观的。比较接受全舌切除术 (TG) 或全舌切除加喉切除术 (TGL) 治疗晚期舌鳞状细胞癌 (SCC) 的患者的功能和生存结果。研究设计。带有图表回顾的案例系列。设置。学术高等教育转诊中心。主题和方法。共有 30 名患者（20 名 TG，10 名 TGL）。结果包括肿瘤复发、无病生存和功能数据（吞咽、胃造口管依赖性、言语、气道）。结果。患者平均年龄为 56 岁，其中男性占多数 (90%)。与 TG 相比，TGL 更常用于治疗复发性肿瘤（90% vs 55%，P = .06）。 TGL 组中神经周围侵犯和囊外扩展更常见（80% vs 50%，P = .12）。术后 12 个月时，61% 的 TG 患者出现疾病复发，而 TGL 患者的这一比例为 40% (P = .43)，12 个月的无病生存率为 40% (TG) 和 50% (TGL)。从功能上来说，更多的 TG 患者完全依赖胃造口管（70% vs 30%，P = .04），50% 的 TG 患者还依赖气管造口管。 30% 的 TG 患者和 10% 的 TGL 患者实现了清晰的言语 (P = .68)。结论。尽管存在更局部晚期疾病和更大的不良病理特征，但接受 TGL 的患者与单独接受 TG 的患者具有相似的功能和生存结果。单独进行 TG 后，阳性或紧密切缘最常见于切除的下缘（舌骨/谷），这可以解释为什么晚期舌 SCC 患者的 TGL 可以改善局部疾病控制。
Objective. To compare functional and survival outcomes for patients undergoing total glossectomy (TG) or total glossectomy plus laryngectomy (TGL) for advanced squamous cell carcinoma (SCC) of the tongue.Study Design. Case series with chart review.Setting. Academic tertiary referral center.Subjects and Methods. There were 30 included patients (20 TG, 10 TGL). Outcomes included tumor recurrence, disease-free survival, and functional data (swallowing, gastrostomy tube dependence, speech, airway).Results. Mean patient age was 56 years with a male predominance (90%). Compared with TG, TGL was more commonly performed for recurrent tumors (90% vs 55%, P = .06). Perineural invasion and extracapsular extension occurred more commonly in the TGL group (80% vs 50%, P = .12). At 12 months postoperatively, 61% of TG patients had disease recurrence compared with 40% of TGL patients (P = .43), and 12-month disease-free survival was 40% (TG) and 50% (TGL). Functionally, more TG patients were totally gastrostomy tube dependent (70% vs 30%, P = .04), and 50% of TG patients were also tracheostomy dependent. Intelligible speech was achieved by 30% of TG and 10% of TGL patients (P = .68).Conclusion. Patients undergoing TGL had similar functional and survival outcomes to patients undergoing TG alone despite the presence of more locally advanced disease with greater adverse pathological features. Following TG alone, positive or close margins occurred most commonly at the inferior margin of resection (hyoid/valleculae), which could explain why TGL in patients with advanced tongue SCC may improve local disease control.