성문상부암에서 성문상후두부분절제술의 치료결과
Clinical Outcome of Supraglottic Laryngectomy in Supraglottic Cancer : Open vs Transoral Laser Supraglottic Laryngectomy
Background and Objectives:When treating the supraglottic cancer, we must consider functions such as respiration, phonation, safe procedure that can preserve the laryngeal function. However, in immediate perioperative time, supraglottic laryngectomy requires tracheostomy and L-tube insertion. On the other hand, transoral laser supraglottic laryngectomy, while it is debated whether or not it is oncologicaly safe, it doesnt require tracheostomy and L-tube insertion. We compared and analyzed the out-comes and morbidity of both treatments. Subjects and Method:Patients who have been diagnosed as supraglotic cancer be-supraglotic laryngectomy for the primary treatment were included in the study. We analyzed the overall survival and treatment results through retrospective chart review and the statistical analysis was carried out by the SPS 10.0. Results:Five-year overall survival rate was 88.5% in open surgery and 78.2% in transoral surgery. But the p-value of 0.216 indicates that there is no statistically significant diferences among two groups. Five-year disease free survival rates were 83.4% in open surgery and 68.0% in transoral surgery. The p-value of 0.221 again indicates that there is no statistically significant diferences among two groups. Tracheostomy and L-tube insertion were conducted in all of the patients in open surgery but conducted in 20% and 6.7% of the patients, respectively, in transoral surgery. Conclusion:There are no diferences between the 5-year overal survival rate and 5-year disease fre survival rate betwen the two groups. However, morbidity is lower in the transoral group, so it would be using more cases are recommended. (Korean J Otorhinolaryngol-Head Neck Surg 2007 ;50 :1130-4)
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