Head & neck · 2012
Extended voice-sparing surgery in selected pyriform sinus carcinoma: techniques and outcomes.
Сравнительное исследованиеОценочное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Hamoir Marc, Fievez Juliette, Schmitz Sandra, Velasco Dorris, Lengele Benoît
Аннотация
BACKGROUND: Organ-preservation approaches are frequently favored in the treatment of advanced pyriform sinus carcinoma. In selected cases, use of free flaps allows voice-sparing surgery.
METHODS: Thirteen patients underwent conservative extended laryngopharyngectomy. In 11 patients, the resection included the supraglottic larynx, whereas the whole hemilarynx was resected in 2. Reconstruction was achieved with a radial forearm free flap with the palmaris longus tendon. In hemilarynx resection, a costal graft was also used. Functional results were assessed by nasofibroscopy and swallowing videofluoroscopic tests.
RESULTS: At 12 months, no patient was gastrostomy dependent, whereas 1 patient remained tracheostomy dependent. At 1, 3, and 5 years, the locoregional control was 100%, 100%, and 83%; overall survival was 69.4%, 46.3%, and 30.8%; and disease-specific survival was 81.2%, 54.5%, and 36.4%, respectively.
CONCLUSIONS: In selected patients, extended conservative laryngopharyngectomy challenges the oncologic results of organ-preservation protocols and allows a good quality of life.
METHODS: Thirteen patients underwent conservative extended laryngopharyngectomy. In 11 patients, the resection included the supraglottic larynx, whereas the whole hemilarynx was resected in 2. Reconstruction was achieved with a radial forearm free flap with the palmaris longus tendon. In hemilarynx resection, a costal graft was also used. Functional results were assessed by nasofibroscopy and swallowing videofluoroscopic tests.
RESULTS: At 12 months, no patient was gastrostomy dependent, whereas 1 patient remained tracheostomy dependent. At 1, 3, and 5 years, the locoregional control was 100%, 100%, and 83%; overall survival was 69.4%, 46.3%, and 30.8%; and disease-specific survival was 81.2%, 54.5%, and 36.4%, respectively.
CONCLUSIONS: In selected patients, extended conservative laryngopharyngectomy challenges the oncologic results of organ-preservation protocols and allows a good quality of life.
Предметные рубрики MeSH
AdultAgedCarcinoma, Squamous CellCohort StudiesDisease-Free SurvivalFemaleFree Tissue FlapsHumansLaryngeal NeoplasmsLaryngectomyMaleMiddle AgedMinimally Invasive Surgical ProceduresNeoplasm InvasivenessNeoplasm StagingPharyngeal NeoplasmsPharyngectomyPostoperative CarePrognosisPlastic Surgery ProceduresRetrospective StudiesSurvival AnalysisTreatment OutcomeVoice Quality