Analysis of clinicopathological stage in supracricoid partial laryngectomy patients: Need for adjuvant therapy in clinically understaged cases

作者：Cho Kwang Jae; Il Sun Dong; Joo Young Hoon; Kim Min Sik^*

来源：Auris Nasus Larynx, 2011, 38(2): 255-260.

DOI：10.1016/j.anl.2010.07.002

• Supracricoid partial laryngectomy
• Understaging
• Adjuvant therapy

Objective: The aim of this study is to evaluate the impact of pre-operative T-understaging on clinical outcome in supracricoid partial laryngectomy (SCPL).
Methods: The medical records of 92 patients who underwent SCPL were evaluated. By comparing clinical and pathologic stages, the causes of pre-operative T-understaging and its relationship with local recurrence and survival were examined.
Results: Fifteen patients (16.3%) were found to be underestimated in terms of pre-operative T-stage, primarily due to failure to identify thyroid cartilage invasion (11 cases). Among these, radiation treatment at the primary site was offered in only two cases, including one case with a positive surgical margin. Among 82 patients followed for over 1 year, local recurrence occurred in seven patients (8.5%); five of these (71.4%) had been understaged pre-operatively due to failure to detect thyroid cartilage invasion. The local recurrence rate was higher and the overall survival rate was lower in patients who were understaged pre-operatively, compared to those who were staged accurately (p = 0.006 and p = 0.001, respectively).
Conclusion: SCPL should be conducted only after a thorough pre-operative evaluation in locally advanced laryngeal cancer. Additionally, adjuvant treatment is necessary to reduce local recurrence in cases where thyroid cartilage invasion is determined pathologically after SCPL.

• 出版日期2011-4