摘要
目的回顾研究了390例术前未行其它治疗而接受手术的声门上型喉癌,探讨声门上型喉癌形态与生物学行为的联系,指导治疗方法。方法 390例中,浸润型179例,结节型83例,二者混合型128例。全喉切除240例,部分喉切除150例。15例未同期行颈淋巴清扫,余均同期行颈清扫,28例同期行双侧颈清扫术。结果原发灶为浸润型、结节型、浸润结节混合型的术后5年生存率分别为55.3%、77.1%和66.3%;术前颈淋巴转移率分别为52.5%、8.43%、35.l%,平均转移率37.4%。N_o、N_(1-3)行单侧颈清扫术后5年内出现对侧颈淋巴转移的分别为14.3%,71.0%。结论浸润型易发生淋巴转移,预后差,治疗时应早期行颈清扫术;结节型不易发生淋巴转移,预后较好,Ⅰ、Ⅱ期可不行颈清扫术。
Purpose We present the results of retrospective study of 390 previously untreated patients who underwent laryngectomy between 1984-1996. To explore the connection between the formation and the biological behavior for directing the surgical treatment. Methods Among 390 patients, 179 cases belong to corrosion type, 83 cases belong to nodule type, and 128 cases belong to corrosion-nodule type. 150 were treated by patial laryngectomy; 240 were treated by total laryngectomy. 15 cases were not treated by neck dissection; 347were treated by one lateral dissection, and 28 cases were treated by bilateral dissection. Results The 5 year survival rates were 55.3% , 77. 1%, 66.3% for corrosion, nodular and corrosion-nodule type respectively. The lymph metastasis rates were 52.5%, 8,43%, 35.1% for corrosive, nodule and corrosion-nodule types respectively. The average metastasis rate was 37. 4% . After a lateral dissection, the opposite neck lymph metastasis rates during the 5 postoperative years were 14.3% and 71.0% for N0 and N1-3 respectively. Conclusion The study showed that all corrosive carcinoma patients have more chances of cervical lymph metastasis and poor prognosis. For all corrosive carcinoma cases, we should give them dissection. All nodule carcinoma patients have fewer chances of cervical lymph metastasis and good prognosis. For Ⅰ , Ⅱ nodule carcinoma patients, we should not give them dissection.
出处
《中国眼耳鼻喉科杂志》
2002年第5期284-287,共4页
Chinese Journal of Ophthalmology and Otorhinolaryngology
关键词
声门上型喉癌
结节型
浸润型
生存率
预后
预淋巴转移
carcinoma of the supraglottic larynx
corrosive type
nodule type
survival rate
prognosis
necklymph metastasis
