喉功能保留的梨状窝癌外科治疗

Laryngeal function-sparing surgery for pyriform sinus cancer

目的 评价喉功能保留梨状窝癌的手术治疗效果。方法 回顾性分析了 1974～ 1994年 6月我院初治的 44例经保留喉功能手术治疗的梨状窝癌病例。其中T110例 ,T2 14例 ,T3 18例 ,T42例。 2例术后放射治疗 ,42例术前放射治疗。原发灶术式包括 :36例梨状窝切除术 ;8例喉及下咽部分切除术。结果 44例 5年生存率为 5 0 % ,I期为 80 % ,II期为 71 43% ,III期为 5 2 9% ,IV期为2 6 7%。总的局部控制率为 81 8%。T3 加T4 的 5年生存率为 45 %。T3 加T4 的 5年局部控制率为75 % (15 /2 0 )。结论 综合治疗过程中选择适宜患者 ,行保留喉功能的梨状窝癌手术 ,可取得满意的治疗效果。术前放射治疗有助于梨状窝癌尤其是T3 梨状窝癌患者喉功能的保留。

Objective To evaluate the oncologic effect of laryngeal function-sparing surgery for the patients with pyriform sinus carcinoma Methods A retrospective analysis was performed Forty-four patients with pyriform sinus cancer who underwent operations were included There were 10 patients in T 1, 14 in T 2, 18 in T 3 and 2 in T 4 categories 42 patients received preoperative radiation and 2 cases, post-operative radiation Surgery for the local lesions: 36 patients underwent pyriform sinusectomy and 8, partial laryngectomy and pyriform sinusectomy Results Five year survival rate is 50% for the whole series, 80% for stage I, 71 4% for stage II, 52 9% for stage III, 26 7% for stage IV and 45% for all T 3+T 4 patients Local control rate is 81 8% for all patients and 75% for T 3,T 4 patients Conclusion For selected pyriform sinus cancer patient a conservative laryngeal surgery is warranted with the combination of preoperative radiative therapy