喉癌术后复发时间的相关因素及预后分析

Correlation factors and prognosis of postoperative recurrence of laryngeal carcinoma

摘要:

目的分析复发性喉鳞状细胞癌患者术后复发时间与其预后的相关性。方法选取2010年6月~2017年3月在我院就诊的41例喉鳞状细胞癌术后复发患者，对相关参数进行单因素和多因素分析，并用Kaplanmeier法对预后进行分析。结果41例患者在术后1～120个月内复发。单因素分析显示临床分期、病理分级与复发时间相关（P＜0.05）；多因素分析显示病理分级（P=0.003）是复发时间的独立影响因素，多因素分析显示初次手术方式是复发性喉癌患者预后的独立影响因素。结论病理分级分化程度低以及临床分期晚的患者更加容易早期复发，应加强随访以助于早期发现，且对≤24个月复发的患者采取更加激进的治疗措施；在激光手术早期开展时T2期患者应慎重选择内镜下手术方式，减少患者术后复发，进而提高患者的生存率。

关键词:喉肿瘤|喉鳞状细胞癌复发|局部|预后

Abstract:

ObjectiveTo investigate the effect of different exposure factors on recurrence time and the association between recurrence time and prognosis via retrospective analysis of recurrent laryngeal squamous cell carcinoma.MethodsA retrospective study was performed to 41 patients with recurrent laryngeal squamous cell carcinoma who were treated in our hospital from June 2010 to March 2017. Univariate and multivariate analyses were performed on related parameters, and prognostic survival analysis was performed by KaplanMeier method.ResultsUnivariate analysis showed that clinical stage and pathological grade were significantly correlated with recurrence time (both P<0.05). Multivariate analysis indicated that pathological grade (P=0.003) was an independent influencing factor of recurrence time, and the initial operative approach was an independent prognostic factor.ConclusionsPatients with low pathological grades and late clinical stages are more likely to have early recurrence, and followup should be strengthened to aid early detection, and more radical treatment measures for patients with postoperative relapse within 24 months. To reduce postoperative recurrence and improve survival rate, endoscopic surgery should be carefully chosen for the patients with T2 laryngeal carcinoma at the early development stage of laser surgery.

Key words:Laryngeal neoplasm|Largrgeal squamous ceu carcinoma|Recurrence| local|Prognosis