142例喉癌手术的远期疗效分析

目的:回顾分析1990年1月至2001年12月间142喉癌手术的远期疗效,以改进治疗提高生存率。方法:对12年间手术治疗满3年的142例进行临床随访,病志分析。结果:男137例,女5例,TsiN0M0(?)例,T1N0M027例,T1N1M01例,T2N0M060例,T2N1M03例,T2N2M01例,T3N0M027例,T3N1M04例,T3N2M03例,T4N0M09例,T4N1M04例,T4N2M01例和T4N3M01例。142例仅4例失访,T1患者的3年生存率为89．2％;5年生存率为76．5％。T2患者的3年生存率为86．7％,5年生存率为73．0％。T3患者3年生存率为60．0％。T4患者3年生存率为63．2％。寿命表法总的3年生存率为77．5％,5年生存率为72．1％,喉功能保存率为61．1％。结论:喉癌预后与发现早晚、有无淋巴结转移、发病部位相关,其治疗效果好,喉功能保存率高;严格掌握手术指征,在保证手术安全边缘的情况下,制定个体化治疗方案,运用最优的切除重建方法,辅助综合治疗,提高生存质量。

Long - term therapeutic effect of surgery on 142 patients with laryngeal carcinoma

Objective: To improve the therapeutic method to raise the survival rate in laryngeal carcinoma surgery. Method: A total of 142 patients (137 males, 5 females) with laryngeal carcinoma surgery from January 1990 to December 2001 were followed up and analyzed their medical histories. Results: One patient was in stage TisN0M0, 27 T1N0M0 , 1 T1N1M0, 60T2N0M0,3T2N1M0,1 T2N2M0,27T3N0M0,4T3N1M0,3T3N2M0,9T4N0M0,4T4N1M0,1 T4N2M0 and 1 T4 N3 M0 . Four cases were out of following - up. The overall 3 - year and 5 - year survival rate was 77.5 % and 72.1 % respectively. In patients with different stages, the 3 - and 5 - year survival rates were as follows: T1, 89.2 % and 76. 5% ; T2, 86.7% and 73 .0% ; T3 and T4, 60.0% and 63 .2% . The laryngeal function was preserved in 67 .0% after operation. Conclusion: The prognosis of laryngeal carcinoma is related to cancer stages, primary area, and lymph node metastasis. To preserve laryngeal function and improve the patients' life quality, doctors should grasp the surgery indications and make the optimal surgical procedure.