改良环状软骨上喉部分切除术治疗中晚期喉癌的疗效及生存质量评估

Survival and life quality evaluation on advanced laryngeal cancer treated with modified supracricoid partial laryngectomy

目的评价改良环状软骨上喉部分切除对中晚期喉癌的生存率及生存质量的效果。方法回顾性统计分析2002~2015年本院经治中晚期喉癌行改良环状软骨上喉部分切除手术患者共65例,其中男62例,女3例;年龄35~80岁;T2级患者26例,T3级32例,T4a级7例。并与同期120例行喉垂直部分切除手术患者的术后功能效果进行对比。结果 T2~T4级喉癌患者行改良环状软骨上喉部分切除术后的5年累积生存率是82.3%,拔管率为98.3%,喉垂直部分切除手术患者的拔管率为86.1%,改良环状软骨上喉部分切除术后拔管率明显优于喉垂直部分切除手术组(P<0.05)。两组患者术后发音质量,误咽情况比较无明显差别(P>0.05)。结论改良环状软骨上喉部分切除是治疗中晚期喉癌可行的手术方式。

OBJECTIVE To evaluate the survival and functional outcomes of advanced laryngeal squamous cell carcinoma after modified supracricoid partial laryngectomy（SCPL）. METHODS We selected 65 laryngeal cancer patients treated with modified supracricoid partial laryngectomy from 2002 to 2015 in our hospital. Among them, 62 cases were males, 3 cases were females with an age ranged from 35 to 80 years（median age 58 years） There were 26 cases with T2 stage, 32 cases with T3 stage and 7 cases with T4 stage. We selected 120 laryngeal cancer patients treated with vertical partial laryngectomy at the same period as control. Then we evaluated the functional outcomes of modified supracricoid partial laryngectomy group compared with vertical partial hemilaryngectomy group. RESULTS The 5-year cumulative survival rate and decannulation rate were 82.3% and 98.3% for supracricoid laryngectomy group respectively. Decannulation ratewas 86.1% for vertical partial hemilaryngectomy group（P〈0.05）. However, there was no significant difference between supracricoid partial laryngectomy group and vertical partial laryngectomy group in pronunciation evaluation and abnormal deglutition. CONCLUSION Modified supracricoid partial laryngectomy is a good choice for local advanced laryngeal squamous cell carcinoma.