KISEP Head and Neck Korean J Otolaryngol 1999;42:1284-9 후두암수술환자에대한치료성적 송달원 김희준 정현수 김영한 안재현 이복수 박선호 Treatment Result in Laryngeal Cancer Patients Submitted to Surgical Treatment Dal Won Song, MD, Hee Jun Kim, MD, Hyun Soo Jeong, MD, Young Han Kim, MD, Jae Hyun Ahn, MD, Bok Su Lee, MD and Sun Ho Park, MD Department of Otolaryngology, School of Medicine, Keimyung University, Taegu, Korea ABSTRACT Background and ObjectivesLaryngeal cancer is the most common malignant tumor within head and neck and is known for having a good prognosis in comparison to the other malignancies. The surgery to the larynx and neck is one of the prime treatment modality for the laryngeal cancer. The purpose of this study is to review the surgical experience of our hospital and to focus on the results of the surgical treatment of the laryngeal cancer. Materials and MethodsAnalyzed 41 laryngeal cancer patients who underwent surgery during the period of 5 years from January 1989 to December 1993. TNM staging of the disease was done by the AJCC staging system issued in 1992. The 5-year survival rate was calculated by Kaplan-Meier method. Results1 The overall 5-year survival rate was 65.8%. 2 The 5-year survival rate according to clinical stage showed 100%, 83.3%, 76.9%, and 50% in stage,,, respectively. 3 The 5-year survival rate according to T stage showed 75%, 66.7%, 57.9%, 77.8%, in T1, T2, T3, T4 respectively. 4 The 5-year survival rate according to nodal status showed N 78.9%, N 56.2%. 5 The 5-year survival rate according to primary site showed supraglottis 60%, glottis 100%, transglottis 57.1%. 6 The 5-year survival rate according to treatment modalities showed surgery only patients 80%, postoperative radiation patients 60%, salvage operation patients 54.6%. ConclusionEarly stage, glottic cancer and the patients who only had operation showed good treatment result. Regional lymph node metastasis, at the time of diagnosis, was found to carry a worse prognosis. The main cause of treatment failure was distant metastasis. Korean J Otolaryngol 1999;42:1284-9 KEY WORDSLaryngeal cancer Surgery. 1284
Table 1. Distribution by site and stage of laryngeal cancer Supraglottic Glottic Transglottic Total Stage 1 1 0 2 1 4 1 6 10 1 2 13 8 1 11 20 Total 20 7 14 41 Table 2. Distribution of cases by TN stage and site N0 N1 N2 N3 Total Supragottic T1 1 2 3 T2 1 1 2 T3 5 5 1 1 12 T4 1 1 1 3 Total 8 6 5 1 20 Glottic T1 1 1 T2 4 4 T3 1 1 T4 1 1 Total 5 2 7 Transglottic T2 1 1 2 T3 1 1 5 7 T4 4 1 5 Total 6 2 6 14 Table 3. Method of surgical treatment according to T-stage T-stage Surgical modalities T1 T2 T3 T4 Total Supraglottic cancer 3 2 12 3 20 Total laryngectomy 1 3 3 7 Supraglottic laryngectomy 3 1 7 11 Extended supraglottic laryngectomy 2 2 Glottic cancer 1 4 1 1 7 Total laryngectomy 1 1 1 3 Hemilaryngectomy 1 3 4 Transglottic cancer 2 7 5 14 Total laryngectomy 1 7 5 13 Hemilaryngectomy 1 1 Total 4 8 20 9 41 1285
Fig. 1. Overall 5-year survival curve. Table 4. Methods of surgical treatment according to N stage Bilateral Unilateral MRND SND RND/MRND RND MRND SND Supraglottic N0 3 4 N1 2 4 N2 1 1 2 1 N3 1 Glottic N0 4 N1 1 N2 N3 Transglottic N0 1 1 2 N1 2 N2 2 2 2 N3 Total 4 7 4 3 17 1 false positive60.7%, false negative1.9% Fig. 2. 5-year survival curve by stage. Table 5. Postoperative complication and site of failure Complication No. Pharyngocutaneous fistula 7 Stomal stenosis 5 Dysphagia 3 Laryngeal stenosis 2 Carotid artery rupture 1 Wound disruption 1 Site of failure Primary site 1 Neck 5 Distant metastasis 8 Fig. 3. 5-year survival curve by T stage. 1286 Korean J Otolaryngol 1999;42:1284-9
Fig. 4. 5-year survival curve by nodal state. Fig. 5. 5-year survival curve by Site. Fig. 6. 5-year survival curve by treatment modalities. 1287
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