保留喉功能手术治疗梨状窝癌患者生存分析

Survival Analysis on the Pyriform Sinus Carcinoma Patients Performed Laryngeal Function Preservation Surgery

目的探讨保留喉功能手术治疗梨状窝癌患者生存情况。方法对2001年10月~2011年12月在我院行保留喉功能手术治疗的20例梨状窝癌患者进行回顾性分析。其中T1期5例,T2期6例,T3期4例,T4期5例。术前放疗1例,术后进行放疗13例,6例单纯行手术治疗。原发灶手术方式包括：梨状窝切除术6例;下咽部分切除及喉部分切除术14例。所有患者均行颈淋巴结清扫。结果 20例患者均完成手术治疗。所有患者均获随访,随访时间平均51（25~72）个月。T1和T2期患者3年生存率明显高于T3和T4期患者（P〈0.05）,联合放疗者生存率明显高于单纯手术者（P〈0.05）,不同病理分化程度患者生存率无统计学差异（P〉0.05）。20例患者术后均可发音,16例（80%）患者呼吸功能得以保存。2例患者分别因严重误咽和窒息死亡。结论 T分期与联合放疗是影响梨状窝癌患者预后的主要因素。

Objective To explore the survival rate of the pyriform sinus carcinoma patients received laryngeal function preservation surgery. Methods A total of 20 pyriform sinus carcinoma patients performed laryngeal function preservation surgery in our hospital from 2001 October to 2011 December were analyzed retrospectively,including 5 cases of stage T1,6 cases of stage T2,4 cases of stage T3,and 5 cases of stage T4. 1 case was performed preoperative radiotherapy,13 cases were carried out post-operative radiotherapy,and 6 cases were treated by operation treatment. The primary operation was as follows： 6 cases received pyriform sinus resection,14 cases performed hypopharyngeal resection and partial laryngectomy. All cases were carried out cervical lymph node dissection. Results 20 cases were complete the surgery successfully. All cases were followed up for 25 to 72 months with an average of 51 months. The survival rate of T1 and T2 period patients was significantly higher than that of T3 and T4 stage patients（ P〉 0. 05）,and the survival rate of the cases treated by surgery combined with radiotherapy was remarkable higher than that of the cases treated by pure surgical treatment（ P 〉0. 05）. There was no statistical difference in the different degree of pathological differentiation（ P〉 0. 05）. 20 patients preserved the pronounce function,and 16 patients preserved respiratory function. 2 cases died of severe aspiration and urgent asphyxia respectively. Conclusion T staging and surgery combined with radiotherapy are the main factors affecting the prognosis of pyriform sinus carcinoma patients.