[Surgical management and preservation of laryngeal function for senile patients with advanced laryngeal carcinoma].
OBJECTIVE
To explore the methods of surgical treatment and preservation of laryngeal function in senile patients with advanced laryngeal carcinoma.


METHODS
A retrospective data review of 87 advanced laryngeal carcinoma patients aged over 65 years was carried out. Of these 87 patients treated by different modes of surgery, 48 had supraglottic cancer, 35 glottic cancer and 4 subglottic cancer. The surgery modes consisted of major partial laryngectomy in 36 patients, subtotal partial laryngectomy with laryngoplasty in 21 and total laryngectomy in 30. All patients received postoperative radiotherapy to a dose of 50-60 Gy. Kaplan-Meier method was used to analyze the survival.


RESULTS
The overall 3- and 5-year survival rate was 73.2% and 67.4%, respectively. The ultimate rate of larynx preservation was 65.5%. Of 57 patients with partial laryngectomy, 46 were decannulated with a decannulation rate of 80.7%. Yet, in all patients, the nasal feeding tube was removed and food intake per os was resumed. All patients who underwent partial laryngectomy regained their phonation function.


CONCLUSIONS
It is safe and effective to treat and preserve laryngeal function surgically in the senile patients with advanced laryngeal carcinoma. The key points to achieve this are selection of proper patient, renovation of surgical procedure and improvement of surgical skill.
Zhang
Dao-gong
DG
Department of Otolaryngology, Qilu Hospital, Shangdong University, Jinan 250012, China. zhangdaogong1978@163.com
Zhang
Han-bing
HB
Luan
Xin-yong
XY
Pan
Xin-liang
XL
Xie
Guang
G
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D007830:Larynx / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011184:Postoperative Period; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies