[The therapeutic outcomes of surgery on senile patients with laryngeal carcinoma].
OBJECTIVE
To investigate the therapeutic outcomes of Laryngectomy and prognostic factors in senile patients with laryngeal carcinoma.


METHODS
A retrospective study of long-term therapeutic outcomes was performed on 110 patients with laryngeal carcinoma over 65, treated mainly by surgery, from 1990 to 2005. Different kinds of operations were as follows: cordectomy(1 case) or stripping (2 cases) by suspended laryngoscope, laryngofissure (4 cases), vertical partial laryngectomy without tracheotomy (8 cases), vertical partial laryngectomy (8 cases), extended vertical partial laryngectomy (1 case), horizontal laryngectomy (4 cases), subtotal laryngectomy (4 cases), cricohyoidoepiglottopexy (30 cases), Arslan's procedure (8 cases), and total laryngectomy (40 cases). Forty-eight patients were treated with preoperative or postoperative radiotherapy, and five patients were treated with induction chemotherapy followed by radiotherapy.


RESULTS
There were four missing cases among all 110 cases. The 5- and 10-year overall survival rate were 66.6% and 44.2%, respectively. The 5- and 10-year diseases-free survival rate were 57.0% and 38.4%, respectively. The median survival was 84 months. Decannulation rate was 87.1% (54/62). Well-differentiation, surgery alone, node-negative, glottic carcinoma, early stage, partial laryngectomy, non-recurrence and male were favorable prognostic factors with univariate analysis (P < 0. 05). Well-differentiation and surgery without combined therapy were also favorable prognostic factors with multivariate analysis.


CONCLUSIONS
Conservation laryngectomy was an efficient method to treat senile patients with laryngeal carcinoma. Combined therapy should better not be adopted to patients with negative surgical margins.
Xu
Chengzhi
C
Department of Otolaryngology, Head and Neck Surgery, Affiliated First People's Hospital of Shanghai Jiaotong University, Shanghai, 200080, China.
Dong
Ping
P
Xu
Hongming
H
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome