诱导化疗后下咽及声门上癌经口视腔喉镜手术治疗

伸吾 田中, 雅之 冨藤, 幸仁 荒木, 彰浩 塩谷
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引用次数: 0

摘要

我们对诱导化疗后的下咽癌和声门上癌行经口视频喉镜手术治疗。回顾性分析24例下咽及声门上癌患者的临床资料。主要肿瘤部位为下咽20例,声门上4例。II期、III期、IVA期和IVB期肿瘤患者分别为3例、4例、15例和2例。虽然平均观察期较短(33个月),但3年总生存率为86%,疾病特异性生存率为94%,喉部保存率为94%。肿瘤结果及喉保存率均良好。病理结果表明,由于可能存在卫星残留癌,必须警惕局部复发。原则上,切除面积应根据原肿瘤的扩展范围设置。虽然部分病例缩小了切除面积,但我们不能断定是否所有病例都能安全缩小切除面积。我们还研究了辅助(化疗)放疗的必要性。如果根据原肿瘤扩展、阴性切缘、pT1-2和pn1 -1确定切除面积,则可以保留辅助放疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transoral Videolaryngoscopic Surgery for Hypopharyngeal and Supraglottic Cancer after Induction Chemotherapy
We performed transoral videolaryngoscopic surgery (TOVS) for hypopharyngeal and supraglottic cancer after induction chemotherapy. The data of 24 patients with hypopharyngeal and supraglottic cancer were retrospectively analyzed. The main tumor site was the hypopharynx in 20 cases and the supraglottis in 4 cases. The number of patients with stage II, III, IVA and IVB tumors were 3 , 4 , 15 and 2 , respectively. Although the mean observation period was relatively short (33 months), the 3-year overall survival was 86%, the disease-specific survival was 94% and the laryngeal preservation rate was 94%. The oncological results and laryngeal preservation rate were excellent. The pathological findings showed that caution must be taken against local recurrence because of possible satellite residual cancer. In principle, the resection area should be set according to the original tumor extension. Although the resection area was reduced in some cases, we cannot conclude whether or not the resection area can be safely reduced in all cases. We also examined the need for adjuvant (chemo) radiotherapy. If the resection area was set according to the original tumor extension, negative margin, pT1-2 and pN0-1 , adjuvant radiation therapy may be preserved.
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