Supracricoid partial laryngectomy cricohyoidoepiglottopexy (SCPL-CHEP) versus vertical partial laryngectomy for the trea
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LARYNGOLOGY
Supracricoid partial laryngectomy cricohyoidoepiglottopexy (SCPL-CHEP) versus vertical partial laryngectomy for the treatment of glottic carcinoma Si-Yi Zhang • Zhong-Ming Lu • Liang-Si Chen • Xiao-Ning Luo • Ping-Jiang Ge • Xin-Han Song • Shao-Hua Chen • Yi-Long Wu
Received: 3 September 2012 / Accepted: 19 October 2012 / Published online: 16 December 2012 Ó Springer-Verlag Berlin Heidelberg 2012
Abstract The study aimed to compare the survival rate and functional outcome of supracricoid partial laryngectomy cricohyoidoepiglottopexy (SCPL-CHEP) and vertical partial laryngectomy (VPL) in the treatment of glottic carcinoma. Thirty-nine patients underwent SCPL-CHEP and 45 patients underwent VPL between 2002 and 2007. Post-operative clinical staging were performed according to the UICC staging criteria (2002). The primary endpoints were survival time and recurrence rate. The secondary endpoints were the laryngeal functions including pronunciation, swallowing, and respiration. Overall, the estimated mean survival time was 75.6 months. There was no significant difference in survival times between the two groups (P = 0.496). The SCPL-CHEP group had a significantly lower post-operative local recurrence rate than VPL group (2.6 vs. 17.8 %, P = 0.033). Significantly longer nasogastric tube removal (22 vs. 14 days, P \ 0.001) and tracheostomy decannulation (38.5 vs. 15 days, P \ 0.001) times in SCPL-CHEP group was observed with the VPL group, respectively. Significantly higher aspiration rates were observed at 3, 6, and
S.-Y. Zhang Z.-M. Lu Southern Medical University, Guangzhou 510515, China S.-Y. Zhang Z.-M. Lu L.-S. Chen X.-N. Luo P.-J. Ge X.-H. Song S.-H. Chen (&) Department of Otorhinolaryngology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, No.106, ZhongShanEr Road, Guangzhou 510080, China e-mail: [email protected] Y.-L. Wu (&) Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, No.106, ZhongShanEr Road, Guangzhou 510080, China e-mail: [email protected]
12 months in the SCPL-CHEP group compared with the VPL group (P \ 0.001, P \ 0.001, P \ 0.05, respectively). Although the survival rate was not significantly different between the two groups, the local regional control rate and organ preservation in the supracricoid partial laryngectomy cricohyoidoepiglottopexy group was better than those observed in the vertical partial laryngectomy group. Keywords Glottic carcinoma Laryngectomy Organ preservation Supracricoid partial laryngectomy cricohyoidoepiglottopexy Vertical partial laryngectomy
Introduction Overall, the incidence of head and neck squamous cell carcinoma is eighth among all the cancers worldwide [1, 2]. Among these head and neck cancers, the incidence of laryngeal cancer accounts for about one-fourth of the worldwide incidence of cancer, and that incidence has been increasing by 25 % annually [3, 4]. In southern China, cancer of the glottic type is the predominant type of laryngeal cancer [5]. Traditional
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