[Surgical treatment of advanced laryngeal cancer with preservation of laryngeal function].
OBJECTIVE
To explore the surgical methods for advanced laryngeal cancer and long term effects of laryngectomy.


METHODS
Two hundred and thirty-eight cases of laryngeal cancer at different stages, including 103 cases with supraglottic cancer, 118 cases with glottic cancer, 3 cases with subglottic cancer, and 14 cases with recurrent cancer, underwent different kinds of operation from 2000 to 2010. The TNM classifications were as follows: T3 168 cases, T4 70 cases. Stage III 145 cases, Stage IV 93 cases. N0 134 cases,N1 64 cases,N2 38 cases, and N3 2 cases. The effects of operation, especially with the preservation of laryngeal function, was analyzed. The disease-free survival rate was calculated by Kaplan-Meier methods.


RESULTS
Partial laryngectomy was performed on 142 of the 238 cases (59.7%). Total laryngectomy was performed on 96 cases. In 142 patients who received partial laryngectomy with preservation of laryngeal function, the trachea cannula was extracted in 90 patients, with the decannulation rate as 63.4%. The nasal feeding tube was removed and peroral feeding was recovered in all patients. The patients undergoing partial laryngectomy succeeded in phonation. The 3 years and 5 years disease-free survival rates in all patients were 81.4% and 59.5%. The 3 years and 5 years disease-free survival rate of partial laryngectomy were 82.9% and 64.3%. The 3 years and 5 years disease-free survival rates in total laryngectomy were 79.2% and 52.4%. There was no significantly different between the two groups (χ(2) = 2.478, P = 0.115).


CONCLUSIONS
For the advanced laryngeal cancer, it is possible to preserve the laryngeal function without compromising the remote survival rate by detailed pre-operational estimation, properly selected operation and skilled surgical practice.
Department of Otorhinolaryngology, Qilu Hospital, Shandong University; Key Laboratory of Otolaryngology, Ministry of Health, Jinan 250012, China.
Tong
T
Jin
Department of Otorhinolaryngology, Qilu Hospital, Shandong University; Key Laboratory of Otolaryngology, Ministry of Health, Jinan 250012, China. Email: panxinl915@126.com.
Xin-liang
XL
Pan
Department of Otorhinolaryngology, Qilu Hospital, Shandong University; Key Laboratory of Otolaryngology, Ministry of Health, Jinan 250012, China.
Da-peng
DP
Lei
Department of Otorhinolaryngology, Qilu Hospital, Shandong University; Key Laboratory of Otolaryngology, Ministry of Health, Jinan 250012, China.
Da-yu
DY
Liu
Department of Otorhinolaryngology, Qilu Hospital, Shandong University; Key Laboratory of Otolaryngology, Ministry of Health, Jinan 250012, China.
Ming
M
Xia
Department of Otorhinolaryngology, Qilu Hospital, Shandong University; Key Laboratory of Otolaryngology, Ministry of Health, Jinan 250012, China.
Dong-min
DM
Wei
Department of Otorhinolaryngology, Qilu Hospital, Shandong University; Key Laboratory of Otolaryngology, Ministry of Health, Jinan 250012, China.
Ye
Y
Qian
Department of Otorhinolaryngology, Qilu Hospital, Shandong University; Key Laboratory of Otolaryngology, Ministry of Health, Jinan 250012, China.
Rui-jie
RJ
Sun
Department of Otorhinolaryngology, Qilu Hospital, Shandong University; Key Laboratory of Otolaryngology, Ministry of Health, Jinan 250012, China.
Guang
G
Xie
Department of Otorhinolaryngology, Qilu Hospital, Shandong University; Key Laboratory of Otolaryngology, Ministry of Health, Jinan 250012, China.
Xin-yong
XY
Luan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome; D055815:Young Adult