An evaluation of surgical techniques and oncologic results in early glottic cancers

Yıl 2003, Cilt: 10 Sayı: 5, 194 - 198, 18.10.2003

M. Kezban Gürbüz Erkan Özüdoğru Hamdi Çaklı Emre Cingi Cem Keçik Cemal Cingi

Öz

Objectives: We evaluated the surgical techniques employed and survival rates in patients who were treat- ed for early glottic cancer.Patients and Methods: The study included 29 patients 28 males, 1 female; mean age 59 years; range 47 to 73 years who unden/vent surgery for early glottic cancer. Surgical techniques were employed in view of factors such as involvement of the anterior commissure, the extent of sub- or supraglottic invasion, and cord mobility. Two- and five- year survival rates were calculated. TNM classification was made according to the 1992 AJCC staging system.Ffesults: Preoperative tumor stages were TjsN0 n=2, 7% , T ^ g n=20, 69% , and T2N0 n=7, 24% . Surgical tech- niques included laryngofissure and cordectomy n=9,31% , frontolateral laryngectomy n=18, 62% , and vertical hemi- laryngectomy n=2, 7% . Positive surgical margins were reported postoperatively in 10 patients, eight of whom remained tumor-free with n=4 or vvithout n=4 radiation therapy during the follow-up period, while two patients unden/vent total laryngectomy because of local recurrences.Three patients died due to causes other than the primary disease. Two- and five-year survival rates were 88.8% and 80%, respectively.Conclusion: İnvolvement of the anterior commissure, and the extent of invasion to the subglottis, supraglottis, and the laryngeal ventricle seem to play a majör role in selecting the most appropriate surgical technique in early glottic cancer

Anahtar Kelimeler

Carcinoma, squamous cell/classification, glottis/ surgery, laryngeal neoplasms/classification/surgery, laryngectomy/methods, neoplasm recurrence, local, neoplasm staging, survival rate

Erken evreli glottik kanserlerde cerrahi tedavi seçimi ve onkolojik sonuçlar

Öz

A m a ç : Erken evreli glottik kanser tanısı ile cerrahi teda- vi uygulanan olgularda seçilen cerrahi yöntem ve sağka- lım oranları değerlendirildi. Hastalar ve Yöntemler: Çalıflmaya erken evreli glottik kanseri nedeniyle cerrahi tedavi gören 29 hasta alındı. Ön komis- sür tutulumu, sub- veya supraglottik yayılım derecesi ve kord mobilitesi gibi faktörler göz önüne alınarak uygula- nan cerrahi yöntemler ve sağkalım oranları belirlendi. Tü- mörlerin TNM sınıflandırması American Joint Committee on Cancer AJCC 1992 ölçütlerine göre yapıldı. Bulgular: Tümör evreleri iki olguda %7 TisN0, 20 ol- guda %69 T1N0, yedi olguda %24 T2N0bulundu. Dokuz olguda %31 larengofissür+kordektomi, 18 ol- guda %62 frontolateral larenjektomi, iki olguda %7 vertikal hemilarenjektomi yapıldı. On olgunun ameliyat sonrası histopatolojik incelemelerinde cerrahi sınır po- zitifliği belirlendi. Bunların dördü radyoterapi sonrasın- da, diğer dördü rutin kontrollerinde sorunsuz olarak iz- lendi; diğer iki olguda ise nüks nedeniyle total larenjek- tomi yapıldı. Yalnızca üç olgu hastalık dıflı nedenlerle kaybedildi. İki yıllık sağkalım oranı %88.8, befl yıllık sağkalım oranı %80 bulundu. Sonuç: Erken evreli glottik kanserli hastalarda, ön komissür tutulumu, subglottise, supraglottise ve ventri- küle yayılım derecesi uygulanacak cerrahi yöntemin seçiminde büyük önem taflımaktadır

Anahtar Kelimeler

Karsinom, yassı epitel hücreli/sınıflandırma, glottis/cerrahi, larenjeal neoplazmlar/sınıflandırma/cerrahi, larenjektomi/yöntem, neoplazm nüksü, lokal, neoplazm evrelemesi, sağkalım oranı

Kaynakça

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