Oncologic and functional outcomes of open surgery in early supraglottic tumors: is it still a valid technique?
Abstract
Objectives: In this study, we aimed to analyze the oncologic and functional outcomes of supraglottic laryngectomy. Patients and Methods: Medical records of 91 cases 85 males, 6 females; mean age 55.4 years; range 30 to 75 years who underwent surgery due to early supraglottic laryngeal cancer in our clinic were retrospectively analyzed. Statistical analysis was performed using chi-square test and Fisher’s exact test. Mean values were estimated by means of t-test, while survival curves were drawn using Kaplan-Meier method. Results: With respect to oncologic assessment, diseasefree survival rate was 81%, the rate of regional recurrence was 6%, the rate of local recurrence was 8%, the rate of distant metastasis was 7% and the rate of occult neck metastasis was 25%. Metastatic neck disease and extracapsular invasion in the lymphatic ganglia were found to be the most critical parameters in terms of survival. With respect to functional assessment, the mean time of decannulation was 41 days, while the mean time of nasogastric tube removal was 19 days. It was observed that cases with a Forced Expiratory Volume in 1 second FEV-1 of <75% experienced more aspiration-related problems. The functional outcomes were worse in the cases who underwent bilateral neck dissection and postoperative radiotherapy. Conclusion: Open surgery is a more effective treatment modality in the early supraglottic tumors in terms of oncologic and functional outcomes. It should be continued to be use as an alternative method to the novel and expensive technologies including transoral robotic surgery or transoral laser surgery.
Erken evreli supraglottik tümörlerde açık cerrahinin onkolojik ve fonksiyonel sonuçları: Hala geçerli bir teknik mi?
Abstract
Amaç: Bu çalışmada supraglottik larenjektominin onkolojik ve fonksiyonel sonuçları analiz edildi.Hastalar ve Yöntemler: Erken evreli supraglottik yerleşimli larenks kanseri nedeniyle kliniğimizde ameliyat edilen 91 olgunun 85 erkek, 6 kadın; ort. yaş 55.4 yıl; dağılım 30-75 yıl tıbbi kayıtları retrospektif olarak incelendi. İstatistiksel analiz, ki-kare ve Fisher kesin testleri kullanılarak yapıldı. Ortalama değerler t-testi ile hesaplanırken sağkalım eğrileri de Kaplan-Meier yöntemi ile çizildi.Bulgular: Onkolojik değerlendirmede hastalıksız sağkalım oranı %81, rejyonel rekürens oranı %6, lokal rekürens oranı %8, uzak metastaz oranı %7 ve okült boyun metastaz oranı %25 olarak bulundu. Boyunda metastatik hastalık ve lenf gangliyonunda ekstrakapsüler yayılım varlığı, sağkalım açısından en önemli parametreler olarak bulundu. Fonksiyonel değerlendirmede ortalama dekanülasyon süresi 41 gün, ortalama nazogastrik tüp çekilme zamanı ise 19 gün olarak saptandı. Aspirasyona bağlı sorunların birinci saniye zorlu ekspiratuar volüm FEV-1 oranı
Details
| Primary Language | English |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | July 22, 2012 |
| Published in Issue | Year 2012 Volume: 22 Issue: 3 |