喉咽癌手术及综合治疗的临床资料分析

Surgical management of hypopharyngeal cancer

目的 评价喉咽癌喉功能保留术及不保留喉功能手术临床疗效 ,探讨进一步提高喉功能保留术患者 5年生存率的方法。方法 总结分析 1980～ 1999年收治的 2 93例喉咽癌临床治疗效果。其中梨状窝癌 2 2 2例 ,环后癌 13例 ,咽后壁癌 2 1例。采用单纯放射治疗 3 7例 ,单纯手术 56例 ,综合治疗 2 0 0例 ;其中保留喉功能手术 159例 ,不保留喉功能手术 97例。结果 喉功能保留手术与不保留喉功能手术Ⅲ、Ⅳ期 5年生存率分别为 51 3 % (3 9/76)、40 4% (17/4 2 ) ;47 6% (10 /2 1)、43 3 % (2 9/67) ,差异无显著性 (P >0 0 5) ;保留喉功能与不保留喉功能在并发症、肿瘤残存、肿瘤复发等相关因素比较差异无显著性。手术 +放射治疗或化学治疗的综合治疗组明显高于单纯放射治疗组 (P <0 0 5)。结论 喉咽癌保留喉功能手术不影响生存率 ,手术

Objective To investigate the preservation of laryngeal function for the patients with hypopharyngeal cancer Methods Two hundred and ninety-three cases of hypopharyngeal cancer with surgical management were reviewed retrospectively, and 222 cases were originated from pyriform sinus, 13 from post-cricoid, and 21 from posterior pharyngeal wall Radiotherapy (37 cases), operation only (56 cases) and the combined treatment (operation plus radiation or chemotherapy, 200 cases) were adopted 159 cases were treated with function preserved laryngectomy and 97 with total laryngectomy Results The 5 year survival rates of patient with laryngeal function preserved and no laryngeal function preserved were 51 3%, 47 6% (for stage Ⅲ); 40 4%, 43 3% (for stage IV), respectively There were no significant differences in 5-year survival between the functionally preserved group and no functioned group (P>0 05) The analysis of survival rates revealed a significant difference between combined therapy and radiotherapy Conclusion There is no significant difference between the survive rates of function preserved and non-preserved groups Conservation laryngectomy improves the quality of patient′s life, and combined therapy is the best choice for hypopharyngeal cancer