Efficacy of reserving thyroid partial laryngectomy for glottic laryngeal carcinoma / 中国医师进修杂志

ABSTRACT

Objective To compare and evaluate the oncological and functional outcomes between reserving thyroid partial laryngectomy and traditional partial laryngectomy for the treatment of stage T2-3glottic laryngeal carcinoma.Methods One hundred and twenty-eight patients treated from January 1999 to January 2009 were selected from all glottic laryngeal carcinoma patients with stage T2-3,who underwent surgery combined with radiation therapy.A retrospective review was randomized and matched by tumour subsite,TNM stage and age,which were confirmed by pathology and observation without thyroid perichondrium invaded or only local invasion of thyroid cartilage,there was no need to extensively resect laryngeal cartilages.Patients were divided into reserving thyroid partial laryngectomy group(study group) and traditional partial laryngectomy group (control group).Each group included 64 cases,which included T2N0 38 cases,T2N1 6 cases,T2N2 1 case,T3N0 17 cases,T3N1 2 cases.Local control rate,decannulation rate,the 3-year and 5-year accumulative survival rate were compared between two groups.Results The 3-year and 5-year accumulative survival rate were 89.8％ and 84.3％ in study group,91.5％ and 85.4％ in control group,there was no sognificant difference (x2 =1.687,P ＞ 0.05).The local control rate was 91.7 ％ (55/60) in study group and 93.2 ％(55/59) in control group,there was no significant difference (x2 =0.103,P ＞0.05).The decannulation rate was 98.3％ (59/60) in study group and 89.8％(53/59) in control group,there was significant difference (x2 =4.933,P ＜0.05).Conclusions Comparing with traditional partial laryngectomy,reserving thyroid partial laryngectomy is successful for treating properly selected stage T2-3 glottic laryngeal carcinoma.This operation has higher decannulation rate and lower complication,which is effective for reducing surgical invasion and facilitated the resumption of respiratory.