[Surgical therapy of subglottic carcinoma].
OBJECTIVE
To analyze the clinical characteristics, surgical procedures and correlated prognostic factors of the cases with subglottic carcinoma; to seek for the optimal surgical treatment for the patients suffering from subglottic carcinoma.


METHODS
Twenty-four cases with subglottic carcinoma were retrospectively reviewed, the disease-free survival rates of the patients at 3 years were analyzed according to the different T N phases and the surgical modalities.


RESULTS
The free-disease survival rate at 3 years was 50.0% (12/24) for 24 cases with subglottic carcinoma. The survival rates of 19 cases with total laryngectomy was 47.4% (9/19), and the survival rates in T2, T3, T4 phases were respectively 1/1, 6/11, 2/7. The survival rates of 5 cases with partial laryngectomy was 3/5, the survival rates in T2, T3 phases were respectively 3/4, 0/1, and the surgical margins were verified to be positive in 2 of 5 cases being performed partial laryngectomy. The metastasis rate of lymph nodes was 33.3% (8/24). The survival rates of patients with N0, N1, N2 disease were respectively 10/16, 1/4, 1/4. The positive lymph nodes were verified in the neck regions of II-VI and superior mediastinum.


CONCLUSIONS
Prognoses of the cases with subglottic carcinoma were poor, early treatment could result in good effect. Until now total laryngectomy still the mainly treatment of subglottic carcinoma. Only the patients with earlier subglottic carcinoma are amenable to partial laryngectomy and should be given postoperative irradiation. Lymph node metastasis was a very important prognostic factor. Paratracheal lymph nodes are the sentinel nodes for subglottic carcinoma, and it is reasonable to probe the nodes. Once verifying positive lymph node, the typical neck dissection involving I-VI regions and superior mediastinum should be performed.
Wen
Shu-xin
SX
Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Tang
Ping-zhang
PZ
Xu
Zhen-gang
ZG
Qi
Yong-fa
YF
Zhang
Zong-min
ZM
Liu
Ming-bo
MB
Bian
Xue
X
Wang
Jian-hong
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011379:Prognosis; D012189:Retrospective Studies