A Preliminary Study of CO2 Laser Surgery and Open Partial Laryngectomy in Treating T3 Glottic Laryngeal Carcinoma_West China Medical Journal

Authors：

LI Wen ¹ , SHI Liying ² , YANG Liu ¹ , L Hong ¹ , ZHOU Jian. ¹

1. Department of Otolaryngology, Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China; 2. Department of Otolaryngology, the 3rd Affiliated Hospital, Xinxiang Medical College, Xinxiang, Henan 453003, P. R. China;

Corresponding?author：

Keywords：

喉癌; 腫瘤分期; 激光手術; 部分喉切除術

DOI：

10.7507/1002-0179.20130015

Video：

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目的　探討T3期喉癌采用支撐喉鏡下CO2激光切除術和部分喉切除術兩種手術治療方式的臨床治療效果。方法　將2003年8月－2010年7月收治的31例患者按所接受手術方式分為A、B兩組（非隨機分組），A組16例中男15例，女1例，年齡38～72歲，中位年齡51歲；B組15例，均為男性，年齡46～68歲，中位年齡58歲。病變均累及前聯合，A組10例和B組11例累及對側聲帶約1/3。A組選擇支撐喉鏡下CO2激光切除術，B組選擇氣管切開＋部分喉切除術。兩組患者首次術后均未接受放射（放療）或化學治療（化療）。術后第1、3、6、12、24個月門診纖維喉鏡復查。隨訪時間14～78個月。結果　A組5例復發或頸部淋巴結轉移，復發率31.3%；5例患者均行再次手術、頸清掃及放、化療。B組4例復發，復發率26.7%；4例均行全喉切除雙側選擇性頸清掃術，其中3例術后輔以放、化療。兩組復發率比較差異無統計學意義（P＞0.05）。結論　采用支撐喉鏡下CO2激光切除治療T3期喉癌，有望得到類似部分喉切除的臨床治療效果。

Citation： LI Wen,SHI Liying,YANG Liu,L Hong,ZHOU Jian.. A Preliminary Study of CO2 Laser Surgery and Open Partial Laryngectomy in Treating T3 Glottic Laryngeal Carcinoma. West China Medical Journal, 2013, 28(1): 53-55. doi: 10.7507/1002-0179.20130015 Copy

1.	黃志剛, 韓德民, 于振坤, 等. CO2激光手術治療聲門型喉癌療效分析[J]. 中華耳鼻咽喉科雜志，2002, 37(3): 219-222.
2.	范獻良, 張大良, 榮寶剛, 等. 顯微喉鏡CO2激光喉癌切除術的遠期療效觀察[J]. 臨床耳鼻咽喉科雜志, 2005, 19(18): 828-829.
3.	Ambrosch P. The role of laser microsurgery in the treatment of laryngeal cancer [J]. Curr Opin Otolaryngo Head Neck Surg, 2007, 15(2): 82-88.
4.	Vilaseca I, Bernal-Sprekelsen M, Luis Blanch J. Transoral laser microsurgery for T3 laryngeal tumors: prognostic factors [J]. Head Neck, 2010, 32(7): 929-938.
5.	Hinni ML, Salassa Jr, Grant DG, et al. Transoral laser microsurgery for advanced laryngeal cancer [J]. Arch Otolaryngol Head Neck Surg, 2007, 133(12): 1198-1204.
6.	Hafidh M, Tibbo J, Trites J, et al. Radiotherapy for T1 and T2 laryngeal cancer : the Dalhausie University experience [J]. J Otolaryngol Head Neck Surg, 2009, 38(4): 434-439.
7.	Peretti G, Piazza C, Cocco D, et al. Transoral CO(2) treatment for T(is)-T(3) glottic cancer: the University of Brescia experience on 595 patients [J]. Head Neck, 2010, 32(8): 977-983.
8.	Grant DG, Salassa JR, Hinni NL, et al. Transoral laser miscrosurgery for untreated glottic carcinoma [J]. Otolaryngol Head Neck Surg, 2007, 137(3): 482-486.
9.	吳嬌嬌，黃志剛，房居高，等. CO2激光手術治療喉癌的并發癥分析[J]. 中華耳鼻咽喉頭頸外科雜志，2011, 46(2): 118-122.
10.	Beitler JJ, Muller S, Grist WJ, et al. Prognostic accuracy of computed tomography findings for patients with laryngeal cancer undergoing laryngectomy [J]. J Clin Oncol, 2010, 28(14): 2318-2322.
11.	Li B, Bobinski M, Gandour-Edwards R, et al. Overstaging of cartilage invasion by multidetector CT scan for laryngeal cancer and its potential effect on the use of organ preservation with chemoradiation [J]. Br J Radiol, 2011, 84(997): 64-69.
12.	于文斌, 曾宗淵, 陳福進, 等. T3-T4 期聲門型喉癌頸淋巴結轉移情況及其與預后的關系[J]. 癌癥，2006，25(10): 1271-1274.
13.	Waldfahrer F, Hauptmann B, Iro H. Lymph node metastasis of glottic laryngeal carcinoma[J]. Laryngorhinootologie, 2005, 84(2): 96-100.
14.	李樹玲．新編頭頸腫瘤學[M]．北京：科學文獻技術出版社，2002: 761-762.

1. 　黃志剛, 韓德民, 于振坤, 等. CO2激光手術治療聲門型喉癌療效分析[J]. 中華耳鼻咽喉科雜志，2002, 37(3): 219-222.
2. 　范獻良, 張大良, 榮寶剛, 等. 顯微喉鏡CO2激光喉癌切除術的遠期療效觀察[J]. 臨床耳鼻咽喉科雜志, 2005, 19(18): 828-829.
3. 　Ambrosch P. The role of laser microsurgery in the treatment of laryngeal cancer [J]. Curr Opin Otolaryngo Head Neck Surg, 2007, 15(2): 82-88.
4. 　Vilaseca I, Bernal-Sprekelsen M, Luis Blanch J. Transoral laser microsurgery for T3 laryngeal tumors: prognostic factors [J]. Head Neck, 2010, 32(7): 929-938.
5. 　Hinni ML, Salassa Jr, Grant DG, et al. Transoral laser microsurgery for advanced laryngeal cancer [J]. Arch Otolaryngol Head Neck Surg, 2007, 133(12): 1198-1204.
6. 　Hafidh M, Tibbo J, Trites J, et al. Radiotherapy for T1 and T2 laryngeal cancer : the Dalhausie University experience [J]. J Otolaryngol Head Neck Surg, 2009, 38(4): 434-439.
7. 　Peretti G, Piazza C, Cocco D, et al. Transoral CO(2) treatment for T(is)-T(3) glottic cancer: the University of Brescia experience on 595 patients [J]. Head Neck, 2010, 32(8): 977-983.
8. 　Grant DG, Salassa JR, Hinni NL, et al. Transoral laser miscrosurgery for untreated glottic carcinoma [J]. Otolaryngol Head Neck Surg, 2007, 137(3): 482-486.
9. 　吳嬌嬌，黃志剛，房居高，等. CO2激光手術治療喉癌的并發癥分析[J]. 中華耳鼻咽喉頭頸外科雜志，2011, 46(2): 118-122.
10. 　Beitler JJ, Muller S, Grist WJ, et al. Prognostic accuracy of computed tomography findings for patients with laryngeal cancer undergoing laryngectomy [J]. J Clin Oncol, 2010, 28(14): 2318-2322.
11. 　Li B, Bobinski M, Gandour-Edwards R, et al. Overstaging of cartilage invasion by multidetector CT scan for laryngeal cancer and its potential effect on the use of organ preservation with chemoradiation [J]. Br J Radiol, 2011, 84(997): 64-69.
12. 　于文斌, 曾宗淵, 陳福進, 等. T3-T4 期聲門型喉癌頸淋巴結轉移情況及其與預后的關系[J]. 癌癥，2006，25(10): 1271-1274.
13. 　Waldfahrer F, Hauptmann B, Iro H. Lymph node metastasis of glottic laryngeal carcinoma[J]. Laryngorhinootologie, 2005, 84(2): 96-100.
14. 　李樹玲．新編頭頸腫瘤學[M]．北京：科學文獻技術出版社，2002: 761-762.

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West China Medical Journal

A Preliminary Study of CO2 Laser Surgery and Open Partial Laryngectomy in Treating T3 Glottic Laryngeal Carcinoma

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