The Laryngoscope · 2021
Transoral Laser Microsurgery for Glottic Cancer in Patients Over 75 Years Old.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Paderno Alberto, Lancini Davide, Bosio Paolo, Del Bon Francesca, Fior Milena, Berretti Giulia, Alparone Marco, Deganello Alberto, Peretti Giorgio, Piazza Cesare
Аннотация
OBJECTIVES/HYPOTHESIS: Laryngeal squamous cell carcinoma (LSCC) has a non-negligible incidence in elderly patients. However, there is still no clear indication on the ideal treatment for early-intermediate glottic LSCC in this specific age group. Both surgical and nonsurgical approaches may be burdened by complications and sequelae that negatively impact patient's health. In this setting, carbon dioxide transoral laser microsurgery (CO2 TOLMS) is a promising minimally invasive treatment option.
STUDY DESIGN: Retrospective case series in a single tertiary academic institution.
METHODS: Patients who underwent CO2 TOLMS for Tis-T3 glottic LSCC from 1997 to 2017 were reviewed. Demographic, clinical, and tumor characteristics, as well as postoperative complications were recorded. Overall (OS), disease-specific (DSS), recurrence-free (RFS), laryngo-esophageal dysfunction free survivals (LEDFS), and organ preservation (OP) were calculated.
RESULTS: A total of 134 patients (mean age, 80 ± 4 years; median, 79; range, 75-93) were included in the study. Seven lesions were classified as pTis, 65 as pT1a, 22 as pT1b, 35 as pT2, and 5 as pT3. No treatment-related death was observed. Twenty-eight (20.9%) patients reported 10 surgical and 19 medical complications. Five-year OS, DSS, RFS, LEDFS, and OP were 68.9%, 95.4%, 79.5%, 66%, and 92.5%, respectively. Age and comorbidities were associated with OS and LEDFS. Advanced T categories were negatively correlated with OS, DSS, RFS, LEDFS, and OP. Age and comorbidities were not significant risk factors for complications.
CONCLUSIONS: CO2 TOLMS can be considered a valuable therapeutic approach for selected Tis-T3 glottic LSCC even in the elderly given its favorable oncologic outcomes and minimal aggressiveness.
LEVEL OF EVIDENCE: 4 Laryngoscope, 132:135-141, 2022.
STUDY DESIGN: Retrospective case series in a single tertiary academic institution.
METHODS: Patients who underwent CO2 TOLMS for Tis-T3 glottic LSCC from 1997 to 2017 were reviewed. Demographic, clinical, and tumor characteristics, as well as postoperative complications were recorded. Overall (OS), disease-specific (DSS), recurrence-free (RFS), laryngo-esophageal dysfunction free survivals (LEDFS), and organ preservation (OP) were calculated.
RESULTS: A total of 134 patients (mean age, 80 ± 4 years; median, 79; range, 75-93) were included in the study. Seven lesions were classified as pTis, 65 as pT1a, 22 as pT1b, 35 as pT2, and 5 as pT3. No treatment-related death was observed. Twenty-eight (20.9%) patients reported 10 surgical and 19 medical complications. Five-year OS, DSS, RFS, LEDFS, and OP were 68.9%, 95.4%, 79.5%, 66%, and 92.5%, respectively. Age and comorbidities were associated with OS and LEDFS. Advanced T categories were negatively correlated with OS, DSS, RFS, LEDFS, and OP. Age and comorbidities were not significant risk factors for complications.
CONCLUSIONS: CO2 TOLMS can be considered a valuable therapeutic approach for selected Tis-T3 glottic LSCC even in the elderly given its favorable oncologic outcomes and minimal aggressiveness.
LEVEL OF EVIDENCE: 4 Laryngoscope, 132:135-141, 2022.