喉部肉瘤的临床病理特征及预后

  目的  探讨喉部肉瘤的临床病理特征及其预后影响因素。  方法  回顾性分析北京协和医院耳鼻咽喉科1990年1月至2008年12月期间住院治疗的13例喉部肉瘤患者的临床资料, 分析肿瘤的临床病理特性, 以Kaplan-Meier法进行生存率统计并分析临床分期和组织学分级与生存率的关系。  结果  喉部肉瘤患者以男性为主(9/13), 含7种病理类型:恶性纤维组织细胞瘤、平滑肌肉瘤、横纹肌肉瘤、滑膜肉瘤、软骨肉瘤、神经纤维肉瘤、癌肉瘤。12例接受手术治疗, 其中7例术后进行了放疗和/或化疗; 另1例仅行放疗。全部病例平均随访29.3个月, 其中5例出现局部复发, 1例出现远处转移, 5年生存率为38.0%。临床分期和组织学分级对生存率有明显影响(P < 0.05)。  结论  喉部肉瘤预后差, 临床分期和组织学分级与预后相关。

Clinical and Pathological Characteristics and Treatment Outcome of Sarcoma of the Larynx

Objective To determine the clinical and pathological characteristics as well as outcome of sarcoma of the larynx.Methods A retrospective review of 13 patients with laryngeal sarcoma treated in Peking Union Medical College Hospital from January 1990 to December 2008 was taken to identify clinical characteristics,pathological characteristics,and therapeutic modalities.Kaplan-Meier survivals were compared according to T-stage and histological G-grade.Results Sarcoma of the larynx showed a male predominance in all cases (9/13) and presented 7 pathological types:maglignant fibrous histiocytoma,leiomyosarcoma,rhabdomyosarcoma,synovial sarcoma,chondrosarcoma,neurofibrosarcoma,carcinosarcoma.Twelve cases underwent tumor resection,including partial laryngectomy,total laryngectomy,and endoscopic resection.Among them,7 cases underwent postoperative radiological therapy and/or chemical therapy.Another case only received radiological therapy.The average follow up time of all cases was 29.3 months and five-year survival rate was 38.0%.Local recurrence occurred in 5 cases and distant metastasis in 1 case.Survival rate was significantly different according to T-stage and histological G-grade (log-rank,P<0.05).Conclusions Sarcomas of the larynx show poor prognosis.The factors influencing survival rate include T-stage and G-grade.