喉杓会厌襞癌的临床分析

目的 分析喉杓会厌襞癌的临床特征、治疗方式及预后因素.方法 回顾性分析30例原发于声门上区喉杓会厌襞癌患者的临床资料,分析不同T、N分级,不同治疗方式的喉杓会厌襞癌患者3年无瘤生存率.结果 30例中15例有颈淋巴结转移,颈淋巴结转移率为50%,3年无瘤生存率为46.7%(14/30).T2、T3、T4级生存率分别为77.8%(719)、35.3%(6/17)、25.0%(1/4),T2级与T3 T4级患者生存率有显著性差异;NO患者3年无瘤生存率为66.7%(10/15),N 患者为26.7%(4/15),两者有显著性差异.喉全切除术、喉近全切除术及喉部分切除术患者3年无瘤生存率分别为28.6%(2/7)、25.0%(2/8)、66.7%(10/15);单纯手术治疗与综合治疗的生存率分别为57.1%(4/7)、43.5%(10/23).结论喉杓会厌襞癌不易早期诊断,颈淋巴结转移率高,预后差.T分级与颈淋巴结是影响喉杓会厌襞癌的预后因素.根据肿瘤局部浸润范围,部分患者可以行喉部分切除术,NO患者手术时应同时行同侧颈淋巴结清扫术.

Clinical analyses of aryepiglottic fold carcinoma

OBJECTIVE To analyze the clinical characteristics, surgical procedures and related prognostic factors of patients with aryepiglottic fold carcinoma. METHODS Thirty cases with aryepiglottic fold carcinoma were retrospectively reviewed. The 3-year disease free survival rates of the patients were analyzed according to the different T, N stages and the therapeutic modalities. RESULTS Fifty percent (15/30) of the cases were diagnosed with cervical lymph nodes metastases. The 3 year disease free survival rate was 46.7 % (14/30) for all cases with aryepiglottic fold carcinoma. The survival rates of the cases with aryepiglottic fold carcinoma in T2, T3, T4 stages were 77.8 % (7/9), 35.3 % (6/17) and 25.0 % (1/4) respectively. There was a significant difference between the cases with T2 aryepiglottic fold carcinoma and the cases with T3 T4 in survival rates;The survival rates of the cases with N0 and N were 66.7 % (10/15) and 26.7 % (4/15) respectively;there was a significant difference between the cases with N0 and N in survival rate. The survival rates of the patients being performed total laryngectomy, near total laryngectomy, partial laryngectomy were 28.6 % (2/7), 25.0 % (2/8) and 66.7 % (10/15) respectively;The survival rates of the cases being treated surgical procedures alone and combined therapy were 57.1 % (4/7) and 43.5 % (10/23) respectively. CONCLUSION Aryepiglottic fold carcinoma is not easily diagnosed early, and has a poor prognosis. Partial laryngectomy is an available therapeutic method for aryepiglottic fold carcinoma. Due to higher rate of cervical lymph nodes metastasis, the ipsilateral neck dissection should simultaneously be performed when primary cancer was being removed for the cases with aryepiglottic fold carcinoma.