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目的:分析20世纪80年代到21世纪初外科治疗喉癌的远期效果,并且探讨影响预后的因素。方法:应用回顾性调查的方法对315例喉癌患者进行分析,统计患者的生存率和死亡原因。结果:生存5年以上者233例,死亡60例,失访22例。累计生存率曲线统计5年生存率为73.97%,其中早期(Ⅰ期、Ⅱ期)为82.69%,晚期(Ⅲ、Ⅳ期)为62.64%。不同分型的5年生存率分别为声门上型73.76%,声门型82.55%,声门下型55.56%,跨声门型68.75%。喉部分切除术的5年生存率79.89%,喉全切术的5年生存率61.03%。患者5年内死亡的主要原因是局部复发和颈淋巴结转移。结论:早期诊断是提高喉功能保留手术比例和提高生存率的关键,严格掌握各术式适应证,保留足够的安全切缘并加强术后随访是提高生存率的根本。
OBJECTIVE: To analyze the long-term effects of surgical treatment of laryngeal cancer from the 1980s to the beginning of the 21st century and to explore the factors that influence prognosis. Methods: A retrospective survey of 315 cases of laryngeal cancer patients were analyzed, the survival rate of patients and the cause of death. Results: There were 233 cases who survived more than 5 years, 60 died and 22 cases were lost. The 5-year survival rate was 73.97% according to the cumulative survival curve, of which 82.69% in early stage (stage Ⅰ and stage Ⅱ) and 62.64% in late stage (stage Ⅲ and stage Ⅳ). The 5-year survival rates of different types were 73.76% of supraglottic, 82.55% of glottis, 55.56% of supraglottic and 68.75% of trans-glottic. The 5-year survival rate of laryngectomy was 79.89%, and the 5-year survival rate of laryngectomy was 61.03%. The main cause of death within 5 years in patients is local recurrence and cervical lymph node metastasis. Conclusion: Early diagnosis is the key to improve the proportion of surgical operation and the survival rate of laryngeal function. It is essential to strictly master indications of various surgical procedures, to keep sufficient safety margins and to enhance postoperative follow-up.