喉頭保存の立場からみた喉頭癌の治療成績

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  • Long-Term Result of Treatment for Laryngeal Cancer from a Viewpoint of Preservation of the Larynx.

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We have treated 181 patients with laryngeal cancer for the past 16 years (Oct. 1, 1976 to Dec. 31, 1992). The male to female ratio was 19: 1, and their ages ranged from 23 to 90 years with a mean of 65. Of these 181 patients, 69 (38%) had supraglottic type, 103 (57%) glottic type, 9 (5%) subglottic type. The larynx is considered to have been preserved when the patient can breathe through the glottis, swallow without aspiration into the trachea, and phonate. The preservation rates of the larynx for five years were calculated for patients with stages T1 or T2 in each affected region using the Kaplan-Meier method. The five-year larynx preservation rates for supraglottic T1 and T2 cancers were 75% and 36%, respectively, and those for glottic T1 and T2 cancers were 85% and 50%, respectively. To improve the five-year larynx preservation rate, eradication of the disease during primary treatment while preserving the larynx is essential. Usefulness of radiation therapy combined with laser surgery for debulking the cancer mass or with low dose cisplatin administration are now under study.<br>Furthermore, 17 patients died of a second primary cancer, even though the laryngeal cancer was eradicated. Detecting second cancers in the early stage is also important.

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