Long-term clinical outcomes of supracricoid partial laryngectomy with cricohyoidoepiglottopexy for glottic carcinoma

Abstract

Background: Laryngeal carcinoma should be treated with the intent of organ-sparing, and supracricoid partial laryngectomy with cricohyoidoepiglottopexy (CHEP) might be an important option.

Aims/objectives: The purpose of this study was to evaluate the clinical outcomes of glottic carcinoma patients treated with CHEP.

Materials and methods: A series of 164 cases with glottic carcinoma undergoing CHEP from 2006 to 2010 was retrospectively analyzed.

Results: The 10-year overall survival (OS) rate, disease-specific survival (DSS) rate, and disease-free survival (DFS) rate were 77.6%, 78.8%, 74.1%, respectively. The OS, DSS, and DFS of patients with stage T1 were higher than patients with stages T2 and T3. Patients with locoregional recurrence and distant metastases had lower OS and DFS than patients with neither recurrence nor metastasis. The DFS of patients with advanced laryngeal carcinoma was worse than that of patients with early-stage carcinoma. T2 and T3 stages, locoregional recurrence, and distant metastases had predictive value regarding patient survival. Additionally, the decannulation rate of postoperative patients was 95.1%, and the nasogastric feeding tube removal rate was 100%.

Conclusions and Significance: CHEP provided reliable oncologic and functional outcomes, and it should be considered as a standard function-sparing option for glottic T1b, T2, and selected T3 carcinoma patients.

Chinese abstract

背景：喉癌的治疗应以保留器官为目的, 用舌骨会厌固定术（CHEP）进行环上部分喉切除可能是一个重要的选择。

目的：本研究的目的是评价应用CHEP治疗声门癌患者的临床效果。

材料与方法：回顾性分析2006-2010年164例应用CHEP治疗的声门癌病例。

结果：10年总生存率（OS）、特定疾病生存率（DSS）、无病生存率（DFS）分别为77.6%、78.8%、74.1%。T1期患者的OS、DSS和DFS高于T2和T3期患者。与既无复发又无转移的患者相比, 局部复发和远处转移的患者的OS和DFS较低。晚期喉癌患者的DFS比早期喉癌患者差。T2期和T3期、局部复发和远处转移对患者生存有预测价值。术后患者拔管率为95.1%, 鼻胃管摘除率为100%。

结论和意义：CHEP可提供可靠的肿瘤和功能结果, 应作为声门癌t1、t2期患者及选定的t3期患者的标准的功能保留措施。

Keywords:

• Cricohyoidoepiglottopexy
• glottic carcinoma
• laryngeal functional preservation
• survival
• prognosis

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Shanghai Hospital Development Center under Grant SHDC12015114, and the Shanghai Science and Technology Commission under Grant 16411950101.