中晚期舌癌患者扩大根治术的临床疗效分析

Clinical analysis of advanced tongue cancer patients treated with extended radical surgery

目的分析中晚期舌癌患者扩大根治术的临床疗效。方法回顾性分析2002～2012年收治的14例中晚期舌癌患者资料,全部患者行舌癌扩大根治切除术,切除后的组织缺损以带蒂胸大肌皮瓣或游离股前外侧皮瓣进行修复。生存分析采用Kaplan-Meier法。结果 14例患者的皮瓣均存活,其中3例带蒂胸大肌皮瓣出现皮瓣远心端部分坏死,换药后二期愈合。生存分析显示,3年和5年生存率分别为42.86%和21.43%。结论扩大根治术对中晚期舌癌患者疗效较佳,带蒂胸大肌皮瓣或游离股前外侧皮瓣用于修复中晚期舌癌扩大切除后的组织缺损较为理想,具有重要的临床应用价值。

Objective To evaluate the effect of extended surgery in the patients with advanced tongue cancer. Meth- ods There were 14 patients with advanced tongue cancer from December 2002 to December 2012, took extended radi- cal surgery including total glossectomy, partial mandibulectomy, total laryngectomy and reconstruction with PPMMF. The clinical data was obtained from the patients＇charts, including the age, sex, pathological diagnosis, TNM staging, surgical modalites and postoperative course. All the patients were followed up routinely. The survival analysis was per- formed with Kaplan-Meier method. Results Among the 14 patients, all flaps survived and no total necrosis, 3 patients got partial infection and necrosis with secondary healing. The 3 and 5- year survival rates were respectively 42.86% and 21.43%. Conclusion Extended radical surgery is a reasonable treatment clinically for patients with advanced tongue cancer. The PPMMF is an acceptable flap for large-scale reconstruction after advanced tongue cancer, which has the important value of clinical application.