Retrospective analysis of 659 laryngeal squamous cell carcinoma patients treated with open laryngeal function-preserving operations

Abstract

Background: Open laryngeal function-preserving surgery is a common therapeutic strategy for Chinese laryngeal squamous cell carcinoma (LSCC) patients.

Objectives: To explore the fundamental clinical characteristics and survival prognostic factors of LSCC patients treated with open laryngeal function-preserving operations.

Material and methods: about a total of 659 LSCC patients undergoing open laryngeal function-preserving operations were retrospectively reviewed. Kaplan–Meier method, Log-rank test and Cox regression model were performed in survival analyses.

Results: About 612 patients were glottic cancer, followed by 44 cases in supraglottis and 3 cases in subglottis. The number of patients in stage T1, T2, T3 and T4 was 190, 365, 100 and 4, respectively. Nineteen patients had positive cervical lymph nodes. The 5-year overall survival, disease-free survival and disease-specific survival rates were 90.1, 84.9 and 90.7%, respectively. T stage and second primary tumour were independent factors predicting overall survival, while T stage and pathological differentiation were independent risk factors for tumour recurrence and progression.

Conclusions and significance: Open laryngeal function-preserving surgery is a crucial therapeutic strategy for Chinese patients with early and, in some cases, advanced-stage LSCC. Early diagnosis and therapy and sufficient and safe surgical margins are key to improving the survival rate and reducing the risk of relapse in LSCC patients.

Chinese abstract

背景：开放性喉功能保留手术是中国喉鳞状细胞癌患者常用的治疗策略。

目的：探讨接受开放性喉功能保留手术的LSCC患者的基本临床特点及生存预后因素。

材料与方法：回顾性复审了659例接受开放性喉功能保留手术的LSCC患者的临床资料。采用Kaplan-Meier法、对数秩检验和Cox回归模型来进行生存分析。

结果：声门癌612例, 声门上癌44例, 声门下癌3例。T1、T2、T3和T4阶段的患者数分别为190、365、100和4名。19例患者颈部淋巴结阳性。5年总生存率、无病生存率和疾病特异性生存率分别为90.1%、84.9%和90.7%。肿瘤阶段和次生原发性肿瘤是预测总生存率的独立因素, 而肿瘤阶段和病理分化是肿瘤复发和发展的独立危险因素。

结论与意义：开放性喉功能保留手术是中国早期及晚期LSCC患者的重要治疗方法。早期诊断和治疗以及足够的安全的手术保险系数是提高LSCC患者生存率和降低复发风险的关键。

Keywords:

• Laryngeal squamous cell carcinoma
• open laryngeal function-preserving operation
• survival prognosis
• risk factors

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article.

Additional information

Funding

This study was supported by the Science and Technology Innovation Project of Shanghai Shen-kang Hospital Clinical Development Center [grand number SHDC12015114]; the Science and Technology Commission of Shanghai Municipality [grand number 16411950100]; the National Natural Science Foundation of China [grand number 81772878, 30801283, 30972691]; the Shanghai Science and Technology Development Funds [grand number 09QA1401000, 10QA1405900, 14411961900]; the Training Program of the Excellent Young Talents of Shanghai Municipal Health System [grand number XYQ2011055, XYQ2011015]; and the Shanghai Municipal Science and Technology Foundation [grand number 11JC1410802].