Clinical Analysis Of Postoperative Recurrence Related Factors And Complications Of Early Glottic Carcinoma Treated With Radiofrequency Ablation

BackgroundLaryngeal carcinoma(LC)is defined as a malignant tumor of the mucosal epithelial tissue of the larynx,and tumors can occur in the glottic,supraglottic,or subglottic regions.Among them,glottic carcinoma has a better prognosis because it can present with hoarseness in its early stage and is easily detected and treated early.With the development of science and technology,the surgical treatment of early glottic carcinoma has also been continuously updated and developed,and minimally invasive surgical treatment has become an epidemic trend.At present,minimally invasive surgery for early glottic cancer mainly includes:laser microsurgery(TLM),low-temperature plasma radiofrequency ablation(RFA),robotic surgery(TORS).TORS is still not widely available because it is expensive.TLM has become one of the treatment of choice for early glottic cancer.However,with the emergence of RFA,the surgical efficacy of RFA in the treatment of early laryngeal cancer in China has been continuously confirmed in the past decade.RFA becoming one of the treatment methods for early glottic cancer.However,as an emerging technique,there are few relevant studies on the postoperative recurrence influencing factors and complications of glottic carcinoma treated with RFA.ObjectiveTo analyze the postoperative recurrence related factors and complications of early glottic carcinoma treated with RFA.MethodIn this study,we collected the hospitalized data of patients with early glottic cancer admitted to the Department of Throat,Head and Neck Surgery of the First Affiliated Hospital of Zhengzhou University from November 2013 to December 2019.97 patients with early glottic carcinoma treated with RFA were included and followed up for 12 to 86 months,with a median follow-up time of 38 months.The occurrence of postoperative complications and the correlation between postoperative recurrence and factors such as age,anterior commissure involved or not,tumor T stage,surgical type,and pathological grade of the first operation were retrospectively analyzed.ResultsIn this study,97 patients with early glottic carcinoma were treated with RFA.The 3-year local control rate,disease-free survival rate,and overall survival rate were 91.3%,85.5%,and 97.3%,respectively.The 5-year local control rate,disease-free survival rate,and overall survival rate were 81.1%,80.4%,and 91.6%,respectively.Postoperative dyspnea occurred in 6 cases,including 1 case of neck swelling and infection,2 cases of large granulation,and 3 cases of laryngeal stenosis.A total of 14 patients had local recurrence,with an overall local recurrence of 14.43%(14/97),a recurrence time of 4 to 44 months,and a median recurrence time of 14 months,among which 10 cases recurred within 2 years.Of the 97 patients,53 cases had lesions not involving the anterior commissure,with a local recurrence rate of 7.55%(4/53),and 44 cases had lesions involving the anterior commissure,with a local recurrence rate of 22.73%(10/44),and the difference was statistically significant(P=0.034).The local recurrence rate was 8.47%(5/59)in Tis+Tla and 23.68%(9/38)in T1b+T2,and the difference was statistically significant(P=0.037).There was no significant difference in postoperative local recurrence rate among different ages,pathological grades,and surgical types.Conclusion1.In this study,the local recurrence rate rate of early glottic carcinoma treated with RFA was 14.43%.2.Most postoperative local recurrence of early glottic laryngeal cancer treated by RFA occurred within 2 years,and follow-up should be strengthened at 2 years after surgery to achieve early detection and treatment of postoperative recurrence.3.In the treatment of early glottic carcinoma with RFA,the local recurrence rate of patients with anterior commissure invasion is higher than that of patients without anterior commissure invasion,and the local recurrence rate of T1b and T2 stages is higher.Therefore,careful evaluation should be performed to select the appropriate surgical plan in the preoperative.If necessary,open laryngectomy should be selected.