摘要
目的早期声带癌经内镜切除术后，手术切缘的状况对患者预后的影响存在着争议。即使对切缘阳性的患者再次行喉镜检查，也很难见到肿瘤残留。术中行冰冻切片分析，已成为常规再次检查的一种手段。本研究的目的是评估根据术中切缘冰冻结果决定手术切除范围的患者预后影响因素。方法回顾性分析收录有连续随访记录的早期声带癌经内镜CO2激光切除的患者，评估手术时切缘的情况、疾病的复发率以及生存资料。计算出Kaplan—Meir生存率并通过对数秩检验和卡方检验来进行比较。结果纳入2004年2月-2011年9月间75例连续随访的患者。5年生存率和疾病特异性生存率分别为84％和98％。尽管扩大声带切除以获得切缘阴性，12个月内复发（P=0．019）和首次冰冻切缘阳性（P=O．001）的病例，提示较差的生存率。结论早期声带癌C（2激光切除，首次手术术中切缘的冰冻切片阳性结果和早期的局部复发，是整个生存率的不良标志。
Objective/Hypothesis The impact of margin status on the outcomes of early glottic cancer after endoscopic resection is controversial; second look laryngoscopy has shown a low rate of residual cancer, even in margin positive patients. Intraoperative frozen section analysis has been suggested as study was to evaluate and search for predictors of outcomes an alternative to routine second look procedures. The aim of this n patients following endoscopic resection based on intraoperative frozen section margin analysis. Study Design Retrospective chart review. Methods Records of consecutive patients treated for early glottic cancer by endoscopic resection with the CO2 laser were evaluated for margin status at the time of intervention, disease recurrence rate, and survival data. Kaplan-Meir survival rates were determined and subgroups were compared with log-rank test and Chi-square test. Results From February 2004 to September 2011, 75 consecutive patients with complete records were identified. The 5-year overall survival rate and the disease-specific survival rate are 84 and 98%, respectively. Recurrence within 12 months （P=0.019） and initially positive frozen section margins, despite enlarging the cordectomy field to obtain negative margins （P=0.001） , were determined to be predictors for poor overall survival. Conclusions In endoscopic resection of early glottic cancer with the CO2 laser, initial intraoperative frozen section margin involvement during the primary resection and early local recurrence are poor signs for overall survival.
出处
《中国医学文摘（耳鼻咽喉科学）》
2014年第6期333-337,共5页
Chinese Medical Digest(Otorhinolaryngology)
