关键词: 喉肿瘤, 切缘, 激光手术, 复发

Abstract:

Objective   To assess the prognostic factors of local recurrence after endoscopic laser cordectomy for early glottic carcinoma. Methods   Data of 76 patients with early glottic carcinoma (T1a,T1b,T2), who were treated with endoscopic laser cordectomy between January 2000 to February 2012 at single institution, were retrospectively analyzed. Surgical margins were set at about 2mm  and marked. Surgical specimens were fixed in 10% buffered formalin and embedded with paraffin. Sections were stained using hematoxylin-eosin for pathologic examination. Overall survival and disease-free survival were estimated using the Kaplan-meier method. The univariate analyses of prognosis factors with impact on disease-free survival were assessed with the log-rank test. Results   The 5 year overall survival, disease-free survival, and laryngeal preservation were 92.0%, 81.9%, and 96.1% respectively. Univariate analysis revealed that anterior commissure involvement and thyroarytenoid muscle invasion exerted a significant impact on disease-free survival. There was no significant difference in disease-free survival according to the status of surgical margin. Conclusion   The anterior commissure involvement and thyroarytenoid muscle invasion increase the risk of local recurrence for endoscopic laser cordectomy. The positive margin does not show any influence on 5 year disease-free survival, however,  close surveillance is required to avoid over-treatment.

Key words: Laryngeal neoplasm, Cordectomy, Recurrence, Laser surgery