Wyniki leczenia operacyjnego raka krtani w różnych typach laryngektomii częściowej na podstawie materiału własnego

Abstract

The aimof the study was to evaluate the oncological results of laryngeal cancer treatment performed in the Laryngology University Ward in Zabrze in the years 1990–2000, depending on the type of partial surgery applied. Materials and methodsRetrospective clinical material includes 209 patients in whom surgery was a primary treatment method. No distant metastases (M1) or another malignant cancer were found. In all 209 patients the squamous cell carcinoma of various degree of malignancy (G1–G3) was found. The most common operation in the analyzed group was a chordectomy – 83 surgeries (40%), next, vertical partial laryngectomies – 38 (18%), horizontal glottis surgeries – 28 (13%). In 79 patients (38%) partial laryngectomy was complemented with a nodal operation.The median of the observation period was 9 years. Local recurrence, nodal recurrence and distant metastasis are rated as treatment failure. Treatment effectiveness was evaluated with relation to overall survival, disease-free survival, cause specific survival and local control. All the above-mentioned parameters were analyzed with the updated percentages method. The level of statistical significance was assumed to be p≤0.05. ResultsThe best oncological results were observed after vertical operations. In the vertical operations group the most favourable oncological results were noted after chordectomy. 83% overall survivals, 82% disease-free survivals, 93% cause specific survivals and 96% local controls in the 5-year observation. On the other hand, the least favourable treatment results were observed after ¾ subtotal partial operation, after horizontal supraglottic operation and after reconstruction operation with CHP. Statistically significant differences in treatment results between the groups of patients after various types of partial operations were found in relation to local controls and disease-free survivals.