摘要
目的探讨影响喉鳞癌喉部分切除术后复发的相关因素。方法回顾性分析中国医学科学院肿瘤医院头颈外科自2005年1月至2009年7月收治的、行喉部分切除术的183例喉鳞癌患者临床资料，分析术后复发与喉鳞癌患者临床病理特征的关系。结果183例喉鳞癌患者中，术后复发37例，复发率为20．2％。其中单纯原发灶复发19例，单纯颈部复发6例，原发灶及颈部同期复发12例。复发时间为术后2—49个月，中位复发时间为术后8个月。单因素分析显示，吸烟情况、饮酒情况、T分期、pN分期、病理分级、辅助放疗、手术切缘与喉鳞癌复发有关（均P〈0．05）。多因素分析显示，饮酒情况、手术切缘、辅助放疗和pN分期是喉鳞癌术后复发的独立危险因素（均P〈0．05）。全组3年生存率为83．1％，预期5年生存率为71．8％。其中T1-T2期患者的3年生存率为85．5％，预期5年生存率为76．1％；T3-T4期患者的3年生存率为75．6％，预期5年生存率为59．5％。结论早期喉鳞癌患者采用单一的治疗方式即可以达到满意的治疗效果，而中晚期及手术切缘阳性的喉鳞癌患者应考虑辅助放疗的综合治疗模式。
Objective To discuss the clinical relevant factors causing recurrence and failure of laryngeal cancer after partial laryngectomy. Methods The clinical data of 183 patients with laryngeal cancer who underwent partial laryngectomy from January 2005 to July 2009 in our hospital were analyzed retrospectively. 12 selected factors which might cause recurrence including sex, age, smoking condition, drinking condition, laryngeal cancer type, T stage, N stage, clinical stage, pathological grade, mode of operation, radiotherapy and margin status were analyzed. Results In the 183 patients, 37 cases were recurrence, the recurrence rate was 20.2%, 3-year survival rate was 83.1%, and 5-year-expected survival rate was 71.8%. Seven factors, i.e. T stage, N stage, pathological grades, surgical margins, radiotherapy, drinking and smoking condition were associated with recurrence after partial laryngectomy. Multivariate analysis showed that drinking condition, surgical margins, adjuvant radiotherapy and pN stage were the main factors affecting the prognosis of patients with partial laryngectomy, and they all were risk factors. Conclusions Simple surgical treatment of early laryngeal cancer alone can achieve satisfactory therapeutic effect. However, multidisciplinary treatment mode of the operation combined with radiotherapy should be considered for patients with advanced laryngeal carcinoma and positive surgical margins.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2013年第5期377-381,共5页
Chinese Journal of Oncology
关键词
喉肿瘤
肿瘤复发
局部
喉部分切除术
治疗结果
Laryngeal neoplasms
Neoplasms recurrence, local
Partial laryngectomy
Treatment outcome
