[Supracricoid partial laryngectomy for the treatment of laryngeal cancer].

OBJECTIVE: To evaluate the oncological and functional outcomes in patients undergoing supracricoid partial laryngectomy (SCPL). METHODS: Forty-three cases underwent supracricoid partial laryngectomy with functional reconstruction in stage T1b-T4. In these cases, 16 were supraglottic cancers, 21 were glottic cancers, and 2 were subglottic cancers. Three types of supracricoid partial laryngectomy (cricohyoidopexy CHP, cricohyoidoepiglottopexy CHEP and tracheocricohyoidoepiglottopexy TCHEP) were employed accordingly. RESULTS: The 3- and 5-year accumulative survival rates were 90.7% and 83.7% respectively (Kaplan-Meier method). Median follow-up time was 57 months. Decannulation rate was 95.3% (41/43) in those. The mean time of decannulation was 14 days in patients preserved both cricoarytenoid units and 43 days in those only preserved one cricoarytenoid unit. The removal of epiglottis increased the risk of aspiration and prolonged time of decannulation (P < 0.05). CONCLUSIONS: Supracricoid partial laryngectomy for selected laryngeal cancer is feasible. The patients can gain satisfied survival rate and quality of life.

[Clinicopathologic features of primary thyroid lymphoma].

BACKGROUND & OBJECTIVE: Primary thyroid lymphoma (PTL) is a rare disease. It is likely to be misdiagnosed, and its treatment remains controversy. This study was to investigate clinicopathologic features of PTL, and explore proper treatments. METHODS: Records of 22 patients with PTL treated in Cancer Hospital, Chinese Academy of Medical Sciences from Jan.1990 to Jan. 2004 were retrospectively analyzed. RESULTS: Of the 22 patients, 18 were women, 4 were men. The median age is 55 (33-80) years. All patients were B-cell original; according to WHO classification, 16 (72.7%) were diffuse large B-cell lymphoma (DLBCL), and 6 (27.3%) were mucosa associated lymphoid tissue (MALT) lymphoma. Five patients received surgery alone; 7 received radiotherapy after surgery, 6 received chemotherapy after surgery, 4 received chemotherapy and radiotherapy after surgery. With a median follow-up of 42 (1-168) months, 5-year relapse-free survival rate was 34.78%, and 5-year overall survival rate was 37.36%. CONCLUSIONS: PTL typically occurs in women. The majority of PTL is B-cell original; DLBCL, and MALT lymphoma were the most common histological subtypes. Patients with PTL of stage IE or IIE should be treated with surgery-based combined modality.

[The surgical treatment and reconstructive methods in management of hypopharyngeal cancer].

OBJECTIVE: To study the surgical treatment and the long-term effect of different reconstructive methods in surgical treatment of hypopharyngeal cancer. METHODS: A retrospective review of 303 (265 males, 38 females, ages ranging from 32 to 77 years) cases with hypopharyngeal cancer that were treated with surgical treatment from 1965 to 1998 were accomplished. Of the 303 cases, 130 cases were treated with different reconstructive methods and 173 cases without reconstruction. Of the 130 (stage II, 5; III, 16; IV, 109) cases, 94 were originated from pyriform sinus, 18 from posterior pharyngeal wall and 18 from postcricoid. Fifteen patients were reconstructed with free jejunum. Eighty-one patients were performed total pharyngo-larygo-oesophagectomy and gastric pull-up. Ten patients were treated with vascularized colon. Twenty patients were reconstructed with pectorals major myocutaneous flap. Four patients were reconstructed with other methods. Of the 173 (stage I, 7; II, 12; III, 51; IV, 103) cases, 160 were originated from pyriform sinus, 8 from posterior pharyngeal wall and 5 from postcricoid. RESULTS: The overall 3 and 5 years survival rate of 130 patients with reconstruction were 43.2%, 36.4% respectively. The overall 5 years survival rate of 173 patients with no reconstruction was 47.7%. The overall rate of regular swallowing was over 80%. The mortality rate in period of surgery of gastric pull-up and pectorals major myocutaneous flap were 8.6% and 15% respectively. No patients with free jejunum and vascularized colon died. The overall complication rate in nineties was lower than before 1990 (chi2 = 13.457, P = 0.004). The highest complication rate occurred in patients with pectorals major myocutaneous flap. In contrast to other reconstruction methods, the rate of success of swallowing was higher in patients with free jejunum. CONCLUSIONS: In selected patients these reconstruction techniques enable functional rehabilitation of swallowing. Even high survival rate was obtained after extended partial pharyngolaryngectomy.