| Objective:To investigate the prognosis and recurrence factors of advanced laryngeal cancer patients by analyzed the clinical data of advanced laryngeal carcinoma retrospectivelyMethod:The medical records of 110 patients diagnosed with advanced laryngeal cancer in the First Affiliated Hospital of Fujian Medical University from May 2011to May 2016 were collected.followed up for more than 60 months,and 9 cases were lost,with a follow-up rate of 91.8%.SPSS 23.0 software was used for statistical analysis,Kaplan-Meier method was used for survival analysis,Log-rank test was used to analyze the factors affecting prognosis,Cox multivariate analysis was used to analyze the independent risk factors affecting prognosis,Logistic analysis was used to analyze the factors affecting patient recurrence,and Chi-square test was used to analyze the factors affecting local recurrence.Result:1.The 5-year overall survival rate of 110 patients with advanced laryngeal cancer was 54%.and the median survival time was 81 months.Old age,smoking,drinking,high clinical stage,low tumor differentiation,Complete laryngotomy,cervical lymph node metastasis,and vascular and nerve invasion were associated with poor prognosis of laryngeal cancer,with P < 0.05 for each group.The 5-year survival rate of patients who received postoperative radiotherapy and chemotherapy was higher than that of patients who did not receive radiotherapy and chemotherapy,the difference was significant(P < 0.05).There was no significant difference in the5-year survival rate of patients with advanced laryngeal cancer in gender,whether complicated with hypertension,diabetes,and different cervical clearing methods(P > 0.05).2.The recurrence rate of advanced laryngeal cancer was 49%.The factors related to recurrence were: old age,smoking,drinking,high clinical stage,low differentiation of tumor,positive intraoperative margin,cervical lymph node metastasis,and vascular and nerve invasion.The P values of each group were <0.05.In addition,there was a significant difference between groups with low differentiation and cervical lymph node metastasis(P < 0.01).The recurrence rate and local recurrence rate of patients who received postoperative radiotherapy and chemotherapy were lower than those who did not receive radiotherapy and chemotherapy,and the difference was significant(P < 0.05).3.There were 54 patients with recurrence,and the main types for recurrence were:local recurrence(28 cases)and cervical lymph node recurrence(20 cases).Distant metastasis was rare(only 6 cases).4.Independent risk factors affecting the prognosis of laryngeal cancer were advanced age,smoking,drinking alcohol,low level of tumor differentiation,associated with cervical lymph node metastasis,and postoperative radiotherapy and chemotherapy were protective factors.Conclusion:1.Advanced laryngeal cancer has a poor prognosis.Old age,smoking,drinking,high clinical stage,low tumor differentiation,complete laryngotomy,cervical lymph node metastasis,and vascular and nerve invasion are associated with poor prognosis;2.The recurrence rate of advanced laryngeal cancer is high,especially in patients with low pathological differentiation and cervical lymph node metastasis.Postoperative follow-up of such patients should be strengthened to detect recurrent lesions as soon as possible,so as to avoid missing the treatment opportunity;3.The main types of recurrence in advanced laryngeal cancer patients are local tumor recurrence and cervical lymph node recurrence.The primary lesion and cervical lymph node should be actively treated at the first operation;4.Adjuvant radiotherapy and chemotherapy are recommended for patients with advanced laryngeal cancer.5.Old age,smoking,drinking,low differentiation and cervical lymph node metastasis are independent risk factors affecting the prognosis of advanced laryngeal cancer. |
PDF Full Text Request