Analysis Of Related Factors Of Recurrent Laryngeal Squamous Cell Carcinoma After Surgical Treatment

Objective:To analyze the related factors affecting the recurrence of laryngeal squamous cell carcinoma after operation,and to explore the efficacy of local recurrent laryngeal squamous cell carcinomapatients after surgical treatment.Methods:Data of patients with laryngeal squamous cell carcinoma who underwent surgical treatment in our hospital from January 2013 to December 2019 were analyzed retrospectively.Clinical factors that might be associated with recurrent laryngeal squamous cell carcinoma after surgery were selected,and clinical factors were analyzed by chi-square test and Cox regression.SPSS 21.0 was used for statistical analysis,and P<0.05 was considered statistically significant.Results:A total of 173 patients were selected to analyze the related factors of recurrence of laryngeal squamous cell carcinoma after operation.During follow-up,48 patients recurred,and 51 patients died,among them,36 cases(70.6%)died of recurrent laryngeal cancer.Kaplan-Meiershowed that the 3-and 5-year survival rates of patients with recurrence were 32.9%and 10.1%,and those without recurrence were 91.6%and 86.9%.Log-rank test showed that the survival rate of patients with recurrent laryngeal cancer was significantly lower than that of patients without recurrent laryngeal cancer(χ2=65.195,P<0.05).Single-factor analysis using the chi-square test showed that theP<0.05 of smoking history,T stage,clinical classification,surgical margin,suggesting that the local recurrence of laryngeal squamous cell carcinoma may be affected.Cox regression was used for multivariate analysis,and smoking history and surgical margin were independent factors affecting local recurrence of laryngeal squamous cell carcinoma after surgery.Thirteen of the 48 patients with recurrence were finally treated again in our hospital,including 3 cases of partial laryngectomy and 10 cases of total laryngectomy.During the follow-up period,5 cases of total laryngectomy group had recurrence and 6 patients died.Conclusion:Smoking history and incision margin are independent factors affecting the recurrence of laryngeal squamous cell carcinoma after surgery.Patients with laryngeal carcinoma with smoking history are still at higher risk of tumor recurrence even if they quit smoking after surgery.The risk of recurrence of laryngeal cancer in patients with positive margins is higher than that in patients with negative margins,because positive margins mean residual cancer cells,and despite postoperative salvage measures,the therapeutic effect is still poor.Clinicians should first ensure negative margins and then pursue preservation of laryngeal function.Strictly selected recurrent patients with laryngeal function preservation feasibility who underwent partial laryngectomy again had a better surgical effect,but for patients with a wide range of recurrence,the effect of salvage total laryngectomy was still poor,not only the postoperative quality of life was low,but also the risk of recurrence was high.Laryngeal cancer recurrence is usually within 3 years after surgery,so it is necessary to guide patients to regularly go to the outpatient department for reexamination within 3 years after surgery,so as to timely detect recurrence so as to deal with the recurrence as soon as possible and improve the treatment effect.