声门型低分化喉癌21例临床观察

目的探讨声门型低分化喉癌的临床特点、治疗及预后.方法回顾分析我院21例声门型低分化喉癌病例.结果 3年和5年生存率分别为57.1%(12/21)和47.1%(8/17),局部复发率为23.8%(5/21),累计颈淋巴结转移率为47.6%(10/21).有颈淋巴结转移和无颈淋巴结转移患者的5年生存率分别为12.5%(1/8)和77.8%(7/9),存在显著性差异(χ2=4.866,P=0.027).喉部分切除手术的局部复发率为18.2%(2/11),其中6例结合放射治疗均无复发.结论声门型低分化喉癌颈淋巴结转移率高,预后相对较差,建议采用手术结合放射治疗,喉部分切除手术是可行的,颈部N0的患者应行选择性治疗.

Clinical analysis of 57 patients with poorly differentiated carcinomas of the glottis

Objective To determine the clinical characteristic, treatment and prognosis for poorly differentiated carcinomas of the glottis. Methods A retrospective review was conducted in 21 cases of poorly differentiated carcinomas of the glottis treated in our hospital. Results The overall 3-and 5-year survival rates for the entire series of patients were 57.1 % (12/21) and47.1% (8/17), respectively. The locally recurrent rate and cervical metastasis rate were 23.8 % (5/21) and 47.6% (10/21), respectively. The difference in the 5-year survival rates for the patients with and without cervical metastasis, 12.5% (1/8) and 77.8% (7/9), respectively, were statistically significant (X2=4.866, P= 0.027). The locally recurrent rate for partial laryngec-tomy was 18.2% (2/11) and all of patients with partial laryngectomy combined with radiotherapy had no recurrence . Conclusion The patients with poorly differentiated carcinomas of the glottis had high cervical metastasis rate and poor prognosis. The combined therapy with surgery and radiation was supposed to be a priority . The partial laryngectomy was feasible to perform on certain patients. The selective cervical treatment for the patients with poorly differentiated carcinomas of the glottis was recommended.