108例喉癌手术疗效分析

目的总结喉癌的术式及疗效,以改进治疗并提高喉癌患者的生存率和生存质量。方法分析临床随访的108例行手术治疗的喉癌患者资料,其中声门上型33例,声门型71例,声门下型4例,按UICC2002年分期标准,I期27例,II期42例,III期25例,IV期14例。行喉部分切除83例,全喉切除25例。结果108例手术患者1年生存率94.5%,3年生存率81.3%,5年生存率为75.4%。其中声门上型1年生存率86.3%,3年为65.2%,5年为63.2%;声门型1年生存率98.1%,3年为91.1%,5年为84.2%。早期肿瘤(I、II期)1年生存率100%,3年生存率88.4%,5年生存率84.1%;晚期(III、IV期)肿瘤1年生存率87.2%,3年生存率71.8%,5年生存率59.0%。早期与晚期患者之间生存率差异有统计学意义(P<0.01),肿瘤不同发病部位(声门型、声门上型)患者之间生存率差异有统计学意义(P<0.05)。结论严格掌握喉癌手术指征,在保证手术安全缘的情况下,根据不同患者的情况,制定个体化治疗方案,运用最优的手术切除和喉功能重建方法,综合治疗,可有效地提高喉癌患者的生存率和生存质量。

Surgical treatment of 108 patients with laryngeal carcinoma

Objective To evaluate the surgical methods and effects of laryngeal carcinoma for the improvement of patients' survival rate and life quality. Methods A retrospective analysis of long-term therapeutic effect was conducted on 108 laryngeal carcinoma patients treated surgically. The case numbers of supraglottic, glottic and infraglottic laryngeal carcinoma were 18, 86, and 4 respectively. According to the classification system of UICC 2002, the case numbers of stage I, II, III and IV were 27, 42, 25 and 14. Partial laryngectomy was implemented in 83 patients and total laryngectomy in 25. Results The 1, 3, and 5 year survival rates of all 108 laryngeal carcinoma patients were 94.5%, 81.3%, and 75.4% respectively; those of glottic group were 98.1%, 91.1%, and 84.2%; while the rates for supraglottic group were 86.3%, 65.2%, and 63.2% respectively. The 1, 3, and 5 year survival rates were 100.00%, 88.4%, 84.1%, and 87.2%, 71.8%, 59.0% for patients at early stages (stage I and II) and advanced stages (stage III and IV). The differences of survival rates were statistically significant between of the glottic group and supraglottic group (P<0.05), and obviously significant between early and advanced stages (P<0.01). Conclusion The survival rate and life quality of laryngeal carcinoma patients can be improved by individualized and integrative treatment. It is possible to preserve the laryngeal functions without survival compromise by means of proper selection of surgical indication, assurance of safe surgical margin and combination of radiotherapy.