Analysis Of Clinical Efficacy Of 112 Patients With Laryngeal Carcinoma Treated By Surgery

Objective: To investigate the long-term efficacy of surgical treatment of patients with laryngeal cancer,summary treatment experience of patient treated by surgery,and further provide the clinical basis for the selection or improvement of treatment options for patients with laryngeal cancer.Methods: The clinical data of 112 patients with laryngeal cancer admitted to otolaryngology department of the first Affiliated Hospital of Dalian Medical University from January 2002 to December 2012 were analyzed retrospectively.They were mainly followed up by phone,outpatient review or access to previous cases to learn more about the patient's postoperative complications,recurrence,survival time and other three aspects.Inclusion criteria were: squamous cell carcinoma diagnosed as laryngeal squamous cell carcinoma;first diagnosed as laryngeal cancer and undergone surgical treatment;complete case data;follow-up time of not less than 5 years.Exclusion criteria: palliative surgery and laryngeal cancer recurrence;preoperative radiotherapy,chemotherapy or concurrent radiotherapy and chemotherapy;diagnosis of the same time there were other primary malignancies;clinical data are incomplete.In line with the standard cases,including 106 males and 6 females,aged 42-81 years,with an average age of 61.5 years,92 cases of glottis,16 cases of supraglottic and 4 cases of subglottic;According to the TNM stage standard set by the Union for International Cancer Control in 2006,there were 41 cases of stage I(T1N0M0),29 cases of stage II(T2N0M0),25 cases of stage III(including 16 cases of T3N0M0,6 cases of T3N1M0,and 3 cases of T2N1M0),17 cases of stage IV(T2N2M0 2 cases,T3N2M0 1 case,T4N0M0 8 cases,T4N1M0 3 cases,T4N2M0 3 cases).Of them,21 treated by total laryngectomy and 91 treated by partial laryngectomy,47 treated by cervical lymph node dissection at the same period.Finally,SPSS 19.0 soft ware was used to process the data statistically and analyzed by one-way chi-square test.P <0.05 was considered as statistically significant.Survival analysis was performed using Kaplan-Meier method.Results: Of the 112 patients with laryngeal cancer,3 patients were missing(death statistics).The follow-up rate was 97.3% and 34 patients died.The cumulative survival rates at 1 and 5 years were 89.3% and 71.4%.The 1-year and 5-year cumulative survival rates of early stage laryngeal carcinoma(stage I and stage II)were 95.7% and91.4%,respectively,and the advanced stage laryngeal carcinoma(stage III and IV)1-year and 5-year cumulative survival rates were 76.2% and 38.1%.Compared with the5-year survival rate of early laryngeal cancer and advanced laryngeal cancer,statistical analysis,P <0.05,the difference was statistically significant.There were 23 cases of recurrence and metastasis,9 cases in early-stage and 14 cases in advanced-stage,the recurrence rate was 20.5%(23/112),there were 6 cases of supraglottic recurrence,15 cases of glottic recurrence and 2 cases of subglottic recurrence.Among them,12 cases recurred within 1 year,7 cases relapsed in 2 years and 4 cases relapsed in more than 2years.Early and advanced laryngeal cancer recurrence rate comparison,statistical analysis,P <0.05,the difference was statistically significant.The total incidence of postoperative complications was 17.9%(20/112).Common complications occurred in4 cases of pharyngeal fistula,5 cases of neck infection,6 cases of pulmonary infection,5 cases of laryngeal stenosis,the first three collectively referred to as infection,a total of 15 cases,the incidence was 13.4%(15/112).Conclusion: The early-stage laryngeal cancer patients initially treated by surgery have definite effect,high survival rate and low recurrence rate.The prognosis of patients with advanced laryngeal cancer is poor,5-year cumulative survival was38.1%.We should fully considered the scope and depth of tumor invasion for preservation operation to ensure the surgical safety and to reduce the recurrence rate.And close follow-up within 1 year after surgery should be stressed.Multiplecomplications occurred after laryngectomy and infection was the most common.The incidence rate can be reduced before,during and after surgery.