Conservation Treatment for T1·T2 Carcinoma of the Larynx
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概要
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Early cancer of the larynx is sometimes regarded to be successfully treatable with whatever technique applied by skilled experts. However, local control, larynx conservation, and cause-specific survival rates of these lesions are still not 100%. In this paper, 323 patients with glottic cancer of the larynx (142 T1a, 98 T1b and 83 T2) and 68 patients with supraglottic cancer of the larynx (12 T1 and 56 T2) were reviewed retrospectively in detail in order to obtain better treatment outcomes.All patients underwent conservation treatments initially.<BR>With respect to the local control rate, any treatment modality could result in a good treatment outcome for glottic T1a and supraglottic T1 cancer. In contrast, laser surgery alone yielded the worst treatment outcome for glottic T1b and T2 cancer. In addition, for supraglottic T2 cancer, both partial laryngectomy and radiotherapy followed by laser debulking surgery obtained a better local control rate. All local recurrence of laryngeal carcinoma could be successfully remedied by partial laryngectomy, whereas in the case of laser surgery, more than half of the patients showed local repeat recurrence.<BR>No patients with T1a glottic cancer showed neck recurrence. In contrast, 2% with glottic T1b, 2% with glottic T2, 17% with supraglottic T1, and 13% of the patients with supraglottic T2 cancer showed neck recurrence without any further local recurrence.<BR>In total six patients died of distant metastasis without locoregional recurrence. The local recurrence rate showed no significant relationship with the distant recurrence rate, whereas the regional recurrence rate had a significant relationship with the distant recurrence rate (p<0.01).<BR>These results suggest the following : <BR>1) Laser surgery alone is not the indication for the treatment of glottic T1b nor T2 cancer in many cases. Partial laryngectomy is not the indication for the initial conservation treatment of early cancer of the larynx. In contrast, for local recurrence, partial laryngectomy is the most reliable salvage surgery.<BR>2) Although regional recurrence is rare, patients must be followed-up carefully.<BR>3) Although distant metastasis is also rare, care must be taken especially for patients with neck recurrence.
- The Japan Laryngological Associationの論文
The Japan Laryngological Association | 論文
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