| Objective:Currently transoral laser microsurgery(TLM) is the preferred treatment for patients with early glottic laryngeal carcinoma. TLM has the advantages of shorter operative time, less invasive, low cost, fewer complications and good voice restoration. However, the control of tumor recurrence after TLM is still the focus of our concern. This article is to analysis the relapse factors of TLM for patients with early glottis carcinoma.Methods: 66 cases of early glottis carcinoma patients who has got the treatment of TLM from January 2013 to January 2015 in Second Hospital of Jilin University Department of Otolaryngology Head and Neck Surgery was collected, including 53 males and 13 females, ageing from 42 to 84 years old, at the median age of 64 years old. 66 patients were all diagnosed as squamous cell carcinoma(SCC). The postoperative follow-up time is 1 to 3 years. They were performed postoperative laryngoscope 1 time one month for three months、1 time three months after 3 months for one year、1 time 3 months after one year. The retrospective analysis of 66 patients’ clinical data was taken to analyze the relationship between postoperative recurrence with tumor T stage, histological differentiation, anterior commissure involvement and the surgical options. The overall survival ratio and the disease-free survival ratio were estimated by the Kaplan-Meier method.Results: There were 10 cases of recurrence in 66 patients, and the recurrence is 15.15%. Six patients relapse in the first year after TLM, three patients in second year, only one patient recurrence in the third year. The first-year recurrence rate is 60%. The recurrence rate of Tis 、T1a、T1b、T2 were 0(0/9),9.38%(3/32),26.67%(4/15),33.33%(3/10). As the stage T of early glottic laryngeal cancer increased, the recurrence rate was gradually increased. The recurrent rate of no involvement of anteriorcommissure was 9.62%(5/52),but the recurrent rate of involvement of anterior commissure was 35.71%(5/14), and the two groups was statistically significant(X2 test P<0.05).The rate of type II surgery、type III surgery、type IV surgery、type V surgery were 0(0/4), 12.50%(1/8), 18.71%(3/16), 15.79(6/38),and the groups were no statistical significance. The recurrence rate of well-differentiated squamous cell carcinoma was 17.14%(6/35), and the recurrence rate of differentiated squamous cell carcinoma was 11.54%(3/26),and the recurrence rate of poorly differentiated squamous cell carcinoma was 20.00%(1/5).Conclusion: 1. The postoperative recurrence of TLM in patients with early laryngeal cancer is most with a year. The postoperative patients with laryngeal cancer should be regularly reviewed, early detection and early treatment. 2. The recurrence rate of early laryngeal cancer patients with anterior commissure involvement after treatment of TLM was significantly higher than the patients without anterior commissure involvement. 3. The recurrence rate of Tis period and T1 a period of early glottic cancer patients after treatment of TLM was less than the T1 b period and T2 period of glottic cancer. 4. The recurrence of early glottic cancer after TLM treatment had no significant relationship with the tumor pathologic differentiation. 5. The extent of resection of TML in treatment of early glottic cancer should be positively correlated with tumor T period. As the higher tumor T period, surgical should be more extensive. |
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