1115例喉癌患者的生存分析

Survival analysis of 1115 patients with laryngeal carcinoma

目的 了解 2 0世纪 80～ 90年代外科治疗喉癌的远期效果 ,并且探讨影响预后的因素。方法 应用回顾性调查的方法 ,对 1983～ 1996年间中国医科大学第一附属医院耳鼻咽喉科 1115例喉癌患者进行分析 ,统计患者的生存率和死亡原因。结果 生存 5年以上者 780例 ,死亡 2 6 0例 ,失访75例 ,累积生存率曲线统计 5年生存率为 77% ,其中Ⅰ期为 94 %、Ⅱ期为 89%、Ⅲ期为 82 %、Ⅳ期为6 6 %。不同分型的 5年生存率由高到低的顺序是声门型、声门上型、声门下型、跨声门型。喉部分切除术患者的 5年生存率为 85 % ,而喉全切除术患者的 5年生存率为 6 8%。患者 5年内死亡的主要原因是局部复发和转移 (70 % ) ,另有 14 %的死亡者没有弄清他们的死亡原因。结论 近 2 0年我国喉癌治疗水平得到明显提高 ,早期诊断是提高喉功能保留手术比例和提高生存率的关键 ,患者 5年内死亡的原因主要是局部复发和转移。

Objective To study the long-term result of patients with laryngeal carcinoma treated by surgery and the prognostic factors. Methods The survival status of 1115 patients with laryngeal carcinoma which were treated in this department between 1983 and 1996 were restrospectively investigated. Results Overall 5- year survival rate was 77%.Among them,5- year survival rate for patients of stage Ⅰ was 94% ,stage Ⅱ 89%,stage Ⅲ 82%,stage Ⅳ 66%.Patients with glottic cancer had the best prognosis,followed by supraglottic,subglottic and transglottic cancer. Five years survival rate for patients with partial laryngectomy was 85%,whereas,for total laryngectomy was 68%.The causes of failure were local recurrence and metastasis(70%). 14% of dead was not clear. Conclusion Early diagnosis was the key for both larynx preservation and survival rates. Causes of dead were laryngeal recurrence and metastasis.