山东大学耳鼻喉眼学报 ›› 2011, Vol. 25 ›› Issue (3): 18-21.

• 论文 • 上一篇    下一篇

喉癌治疗后复发的临床因素分析及治疗

伊海金1, 张宝泉2, 王春红1, 郭泓1, 倪富强1   

  • 收稿日期:2010-11-23 修回日期:2011-02-28 出版日期:2011-06-16 发布日期:2011-06-16
  • 通讯作者: 张宝泉,教授,博士生导师。Email:dl7599@sohu.com
  • 作者简介:伊海金(1975- ),男,主治医师,主要从事头颈颅底外科方面的临床工作。 Email: nanshanju@tom.com

Clinical analysis and treatment of recurrent laryngeal cancer

YI Hai-jin1, ZHANG Bao-quan2, WANG Chun-hong1, GUO Hong1, NI Fu-qiang1   

  1. 1. Department of Otolaryngology head and neck surgery, Beijing Tiantan Hospital,  Capital Medical University,  Beijing 100050, China;    2. Department of Otolaryngology head and neck surgery, Peking Union Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
  • Received:2010-11-23 Revised:2011-02-28 Online:2011-06-16 Published:2011-06-16

摘要:

目的     探讨喉癌治疗后复发的临床因素以及诊断与治疗。方法      应用χ2检验以及logistic多因素回归分析方法分析114例喉癌的临床复发因素并分析其中23例复发喉癌的临床资料。结果     χ2检验统计结果显示,喉癌术后复发与原发肿瘤部位、分化程度以及T分期有关,与首次手术方式无关;Logestic多因素回归分析显示,切缘阳性是喉癌复发的高危因素。23例复发性喉癌中,喉癌局部复发13例,颈淋巴结转移7例,局部复发并颈淋巴结转移3例。治疗采取放疗、部分喉切除、(扩大)全喉切除及(或)颈廓清术。局部复发组随访5年13例中8例生存,3例死亡,2例失访;颈淋巴结转移组7例中4例生存,2例死亡,1例失访;局部复发并颈淋巴结转移3例,1例存活,1例死亡,1例失访。结论      喉癌手术后复发与原发肿瘤部位、分化程度、T分期以及阳性切缘有关;喉癌术后定期随访有助于早期明确有无复发;对复发性喉癌的治疗仍以手术为主。

关键词: 喉肿瘤;复发性;喉切除术

Abstract:

Objective      To explore clinical factors and treatment of recurrent laryngeal cancer. Methods      The clinical data of 23  recurrent laryngeal cancer cases were reviewed, while the recurrence factors of 78 laryngeal cancers were analyzed by χ2-Test and Logistic Degression analysis. Result       The recurrence of laryngeal cancer was related to location, the grading of pathology and the T stage, but not method of operation. A positive incision margin was a risk factor for recurrence. Among 23 recurrent laryngeal cancer patients,there were 13 local recurrences, 7 cervical metastasis, and 3 local recurrences accompanied  with cervical metastasis. Treatments consisted of radiation therapy, partial laryngectomy, total laryngectomy and radical neck dissection. In 13 cases with local recurrence, 8 patients survived, 3 patients died, and 2 patients were lost during the follow-up. In 7 cases with only cervical metastasis,  4 patient survived, 2 patients died, and 1 patients was lost during the follow-up. As for the other 3 patients with both  local recurrence and cervical metastasis,1 patient survived, 1 patient died, and 1 patient was lost. Conclusion       Laryngeal cancer recurrence is associated with tumor location,  grading of pathology, T stage and a positive incision margin. Regular follow-up is helpful to trace laryngeal cancer recurrence. Surgery is the effective treatment for recurrent laryngeal cancer.

Key words: Laryngeal neoplasm; Recurrence; laryngectomy

中图分类号: 

  • R739.65
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