성문상부암종에서 성문상 후두부분절제술과 경부청소술의 치료성적

Treatment Outcome of Supraglottic Partial Laryngectomy and Neck Dissection for Supraglottic Carcinoma

  • 태경 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 민현정 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 송미나 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 신광수 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 이승환 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 김경래 (한양대학교 의과대학 이비인후-두경부외과학교실) ;
  • 이형석 (한양대학교 의과대학 이비인후-두경부외과학교실)
  • Tae, Kyung (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University) ;
  • Min, Hyun-Jung (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University) ;
  • Song, Mi-Na (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University) ;
  • Shin, Kwang-Soo (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University) ;
  • Lee, Seung-Hwan (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University) ;
  • Kim, Kyung-Rae (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University) ;
  • Lee, Hyung-Seok (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University)
  • 발행 : 2007.05.31

초록

Background and Objectives:Supraglottic partial laryngectomy is oncologically sound surgical procedure for selected cases of laryngeal cancer which maintains physiologic speech and swallowing without permanent tracheostoma. The purpose of this study is to evaluate the oncologic and functional results of supraglottic partial laryngectomy and neck dissection for supraglottic cancer. Materials and Methods:Between 1991-2005, Twenty-three supraglottic cancer patients, underwent supraglottic partial laryngectomy, were studied retrospectively. There were 5 patients with cT1, 14 with cT2, 4 with cT3 and 11 patients with cN0, 1 with cN1, 10 with cN2, 1 with cN3. All patients underwent neck dissection and postoperative radiotherapy was added to twenty patients. They were reviewed with respect to primary subsites, extended subsites, treatment result, survival rate, factors affecting the prognosis, postoperative complication, time of decannulation and oral diet, and postoperative voice. Results:Among eleven patients with clinically negative node, six patients had pathologically positive nodes. So occult metastasis was 54.5%. Two patients recurred at cervical lymph node and one had distant metastasis to lung. Local and regional control were 100% and 91.3%. The overall 3-year and 5-year survival rate were 84%, 78%, respectively. Nineteen cases were squamous cell carcinomas and four were basaloid squamous cell carcinomas. Basaloid subtype was significantly affected to survival. Decannulation and oral feeding were possible in 100%. Conclusions:Supraglottic partial laryngectomy is oncologically safe and functionally good procedure in supraglottic cancers. Elective neck dissection is beneficial in management of occult cervical metastasis.

키워드

참고문헌

  1. Alonso JM: Conservative surgery of cancers of the larynx. Trans Am Acad Ophthalmol Otolaryngol. 1947;51:633-642
  2. Rinaldo A, Ferlito A: Open supraglotic laryngectomy. Acta Otolaryngol. 2004;124:768-771 https://doi.org/10.1080/00016480310000737
  3. Spriano G, Antognoni P, Sanguineti G, et al: Laryngeal longterm morbidity after supraglottic laryngectomy and postoperative radiation therapy. Am J Otolaryngol. 2000;21:14-21 https://doi.org/10.1016/S0196-0709(00)80119-2
  4. Hinerman RW, Mendenhall WM, Amdur RJ, Stringer SP, Villaret DB, Robbins KT: Carcinoma of the supraglottic larynx: treatment results with radiotherapy alone or with planned neck dissection. Head Neck. 2002;24:456-467 https://doi.org/10.1002/hed.10069
  5. Bocca E: Surgical management of supraglottic cancer and its lymph nodes metastases in a conservative perspective. Ann Otol Rhinol Laryngol. 1991;100:261-267 https://doi.org/10.1177/000348949110000401
  6. DeSanto LW: Early supraglottic cancer. Ann Otol Rhinol Laryngol. 1990;99:593-597 https://doi.org/10.1177/000348949009900801
  7. Bron LP, Soldati D, Monod ML, et al: Horizontal partial laryngectomy for supraglottic squamous cell carcinoma. Eur Arch Otorhinolaryngol. 2005;262:302-306 https://doi.org/10.1007/s00405-004-0824-y
  8. Herranz-Gonzalez J, Gavilan J, Martinez-Vidal J, Gavilan C: Supraglottic laryngectomy: functional and oncologic results. Ann Otol Rhinol Laryngol. 1996;105:18-22 https://doi.org/10.1177/000348949610500104
  9. Robbins KT, Davidson W, Peters LJ, Goepfert H: Consevation surgery of T2 and T3 carcinomas of the supraglottic larynx. Arch Otolaryngol Head Neck Surg. 1988;114:421-426 https://doi.org/10.1001/archotol.1988.01860160065023
  10. Ogura JH, Marks JE, Freeman RB: Results of conservation surgery for cancers of the supraglottis and pyriform sinus. Laryngoscope. 1980;90:590-600
  11. Lim YC, Kim SH, Shin YS, et al: Supraglottic partial laryngectomy: oncologic and functional results. Korean J Otolaryngol. 2004;47:1267-1272
  12. Wain SL, Kier R, Vollmer RT, Bossen EH: Basaloid squamous carcinoma of the tongue, hypopharynx and larynx. Hum Pathol. 1986;17:1158-1166 https://doi.org/10.1016/S0046-8177(86)80422-1
  13. Erisen LM, Coskun H, Ozuysal S, et al: Basaloid squamous cell carcinoma of the larynx: a report of four new cases. Laryngoscope. 2004;114:1179-1183 https://doi.org/10.1097/00005537-200407000-00009
  14. Ferlito A, Altavilla G, Rinaldo A, Doglioni C: Basaloid squamous cell carcinoma of the larynx and hypophyrynx. Ann Otol Rhinol Laryngol. 1997;106:1024-1035 https://doi.org/10.1177/000348949710601206
  15. Adamopoulos G, Yotakie I, Apostolopoulos K, Manolopoulos L, Kandiloros D, Ferekidis E: Supraglottic laryngectomy-series report and analysis of results. J Laryngol Otol. 1997;111:730-734
  16. Lutz CK, Johnson JT, Myers EN, Wagner RL: Supraglottic carcinoma: patterns of recurrence. Ann Otol Rhinol Laryngol. 1990; 99:12-17
  17. Weber PC, Johnson JT, Myers EN: The impact of bilateral neck dissection on pattern of recurrence and survival in supraglottic carcinoma. Arch Otolaryngol Head Neck Surg. 1994;120:703-706 https://doi.org/10.1001/archotol.1994.01880310009002
  18. Steiniger JR, Parnes SM, Gardner GM: Morbidity of combined therapy for the treatment of supraglottic carcnoma: supraglottic laryngectomy and radiotherapy. Ann Otol Rhinol Laryngol. 1997; 106:151-158 https://doi.org/10.1177/000348949710600211
  19. Hirano M, Kurita S, Tateishi M, Matsuoka H: Deglutition following supraglottic horizontal laryngectomy. Ann Otol Rhinol Laryngol. 1987;96:7-11 https://doi.org/10.1177/000348948709600102