Evaluation of different methods of transoral minimally invasive surgery for supraglottic laryngeal carcinoma

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-08-08 DOI:10.1002/cnr2.2077

Lingwa Wang, Qi Zhong, Fan Yang, Lizhen Hou, Hongzhi Ma, Ling Feng, Shizhi He, Yifan Yang, Jugao Fang, Ru Wang

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Abstract

Background and objectives

To analyze oncological and functional results of transoral minimally invasive surgery (TMIS) for supraglottic laryngeal carcinoma (SGLC), and investigate independent prognostic factors.

Methods

Seventy SGLC patients treated with TMIS were included. The overall survival (OS), recurrence-free survival (RFS), and postoperative functions were analyzed.

Results

Sixty-two patients were early-stage (Tis, T1, and T2) and eight patients were T3. Eleven patients received preoperative induction chemotherapy (IC). Sixty patients received transoral laser microsurgery (TLM), and 10 patients received transoral robotic surgery (TORS). Fifty-eight patients were scored Grade-1 by water swallow test, and 49 patients were scored Grade 0 by grade, roughness, breathiness, asthenia, strain. The 1, 3, and 5 year OS of all were 95.450%, 84.877%, and 78.026%, and RFS were 89.167%, 78.052%, and 75.451% respectively. Kaplan–Meier survival analysis showed N stage and clinical stage were associated with OS, smoking, clinical stage, surgical margins, and Ki-67 index were associated with RFS. There were no significant differences in preoperative IC or direct surgery, TLM, or TORS. Cox analyses showed smoking and surgical margins were independent prognosis factors for RFS.

Conclusions

The positive margin, Ki-67 index ≥40% and P53(+)&Ki-67 index ≥40% are worse factors affecting recurrence for SGLC patients. Both smoking and surgical margins are independent prognostic factors affecting recurrence.

Abstract Image

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经口微创手术治疗声门上型喉癌的不同方法评估。

背景与目的分析经口微创手术（TMIS）治疗声门上型喉癌（SGLC）的肿瘤学和功能效果，并研究独立的预后因素：方法：纳入70例接受TMIS治疗的声门上型喉癌患者。方法：纳入70例接受TMIS治疗的SGLC患者，分析其总生存期（OS）、无复发生存期（RFS）和术后功能：62例患者为早期（Tis、T1和T2），8例患者为T3。11名患者接受了术前诱导化疗（IC）。60名患者接受了经口激光显微手术（TLM），10名患者接受了经口机器人手术（TORS）。58名患者通过水吞咽测试被评为1级，49名患者通过等级、粗糙度、呼吸困难、气喘、劳累被评为0级。所有患者的 1、3 和 5 年 OS 分别为 95.450%、84.877% 和 78.026%，RFS 分别为 89.167%、78.052% 和 75.451%。Kaplan-Meier生存分析显示，N分期和临床分期与OS相关，吸烟、临床分期、手术切缘和Ki-67指数与RFS相关。术前IC或直接手术、TLM或TORS无明显差异。Cox分析显示，吸烟和手术切缘是RFS的独立预后因素：结论：阳性边缘、Ki-67指数≥40%和P53（+）&Ki-67指数≥40%是影响SGLC患者复发的较差因素。吸烟和手术切缘都是影响复发的独立预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.