Larynx cancer treatment results: survive and quality of life assessment

Yıl 2010, Cilt: 20 Sayı: 1, 25 - 32, 10.01.2010

Davut Akduman Murat Karaman Celil Uslu Ömer Bilaç Özlem Türk Mahmut Deniz Ruhi Durmuş

Öz

Objectives: To make a contribution to the treatment modality of larynx cancer, we evaluated our surgical outcomes of the patients with larynx cancer and their quality of life in the postoperative period. Patients and Methods: Forty-three patients 38 males, 5 females; mean age 57.6 years; range 34 to 84 years with larynx cancer were included in this retrospective clinical study. Total laryngectomy/near total laryngectomy TL/NTL was performed in 29 patients, supracricoid laryngectomy in 13 patients and supraglottic laryngectomy in one patient. Neck dissection performed in 39 patients. Two patients had preoperative and eleven patients had postoperative radiotherapy RT . The patients were evaluated with respect to age, sex, smoking, alcohol consumption, localizationdifferentiation-stage of the tumor, surgery and RT, postoperative complications and survival. QLQ-C30 and QLQ-H and N35 questionnaires were used and the results of 26 patients who were alive and filled in the questionnaires themselves were evaluated. Results: The most frequent postoperative complication was pharyngocutaneous fistula 41.3% , which occurred only in TL/NTL patients. Mean postoperative hospitalization time was 21.2 days. Laryngeal preservation, peristomal recurrence and locoregional recurrence rates were 64.3%, 6.9% and 9.3% respectively. Overall survival rate was 88.8%. Mean survival time was 62.4 months. In quality of life assessment, speech problem p<0.01 and cough index p<0.05 were significantly higher in TL/NTL group than SCL group p<0.05 . There were no significant difference in both groups with respect to RT p>0.05 . Conclusion: Our surgical outcomes are compatible with the previous studies. Although the larynx preservation had a positive effect on the speech, it did not affect other quality of life parameters. In addition, having a permanent tracheostomy increased cough index markedly. We emphasize that multi-institutional prospective quality of life studies comparing different treatment methods for similar stage tumors are essential in defining the optimal management strategy in patients with larynx cancer.

Anahtar Kelimeler

Laryngectomy, larynx cancer, quality of life

Larenks kanseri tedavi sonuçları: Sağkalım ve yaşam kalitesi değerlendirilmesi

Öz

Amaç: Larenks kanserlerinin tedavi yaklaşımına katkıda bulunmak için larenks kanseri cerrahi sonuçlarımız ve hastaların ameliyat sonrası yaşam kaliteleri değerlendirildi.Hastalar ve Yöntemler: Geriye dönük yapılan bu klinik çalışmaya 43 larenks kanserli hasta 38 erkek, 5 kadın; ort. yaş 57.6 yıl; dağılım 34-84 yıl dahil edildi. Hastaların 29’una total larenjektomi/near total larenjektomi TL/NTL , 13’üne suprakrikoid larenjektomi SKL ve bir hastaya da supraglottik larenjektomi uygulandı. Otuz dokuz hastaya boyun diseksiyonu uygulandı. İki hastaya ameliyat öncesi, 11 hastaya ameliyat sonrası, radyoterapi RT uygulandı. Hastalar yaş, cinsiyet, sigara-alkol kullanımı, tümörün yerleşimi-histopatolojisi-evresi, cerrahi ve RT, ameliyat sonrası komplikasyonlar ve sağkalım açısından değerlendirildi. Değerlendirmede yaşam kalitesi QLQ-C30 ve QLQ-H ve N35 anketleri kullanıldı, hayatta olan ve anketleri kendi dolduran 26 hastanın formu değerlendirildi.Bulgular: Ameliyat sonrası komplikasyon olarak en sık görülen farengokütanöz fistül %41.3 , sadece TL/NTL hastalarında gelişti. Ameliyat sonrası hastanede kalış süresi ortalama 21.2 gün idi. Larenks koruma, peristomal nüks ve lokal nüks oranları sırasıyla %64.3, %6.9 ve %9.3 olarak saptandı. Genel sağkalım oranı %88.8 ve ortalama sağkalım süresi ise 62.4 ay olarak bulundu. Yaşam kalitesinin değerlendirmesinde, konuşma sorunları p

Anahtar Kelimeler

Larenjektomi, larenks kanseri, yaşam kalitesi

Kaynakça

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