晚期复发性声门型喉癌挽救性手术的治疗效果和经验分析

Effect and experience of salvage surgery for advanced recurrent glottic cancer

摘要:

目的评估晚期复发性声门型喉癌挽救性手术治疗的方法和效果并总结经验。方法收集中南大学湘雅医学院附属肿瘤医院2008年6月~2013年12月行挽救性手术的54例晚期复发性声门型喉鳞癌患者的临床资料，分析复发患者长期生存率、拔管率和咽瘘发生率，长期生存率采用KaplanMeier法，单因素分析采用logrank检验。结果54例挽救性手术患者中，其3年生存率51.9%，5年生存率23.2%；治疗结束后6个月内拔管率为100%；咽瘘发生率12.5%。结论挽救性手术是复发性声门型喉癌治疗的基础。合理且广泛地切除病灶及周围组织、应用良好的修复咽喉和颈部软组织缺损的技术，是确保复发性喉癌挽救性手术成功的关键。

关键词:喉癌|声门型|复发|挽救性手术|修复|手术疗效

Abstract:

ObjectiveTo evaluate the effect of radical salvage surgery for advanced recurrent glottic cancer, and summarize the surgical methods and treatment experience in our institution.MethodsClinical data of 54 patients with advanced recurrent glottic cancer managed by radical salvage surgery at our institution between June 2008 and Dec. 2013 were analyzed retrospectively. Their longterm survival rate, rate of nasogastric tube removal, and presence of pharyngeal fistula were analyzed. Survival rates were calculated using the KaplanMeier method, and single factor analysis was performed using the logrank test.ResultsOf all the 54 patients, the 3year and 5year survival rates were 51.9% and 23.2% respectively. The rate of nasogastric tube removal within 6 months after treatment was 100%, and occurrence rate of pharyngeal fistula was 12.5%.ConclusionsSalvage surgical resection is the cornerstone treatment for advanced recurrent glottic cancer. Appropriate and extensive surgical resection as well as accurate repair of soft tissue defects were the keys to successful radical salvage surgery.

Key words:Laryngeal cancer|glottic|Recurrence|Salvage operation|Repair|Surgical effect