Efficacy Of Reserving Thyroid Partial Laryngectomy

Objective: To compare and evaluate the oncological and functional outcomes between reserving thyroid partial laryngectomy and other traditional partial laryngectomy for the treatment of stage T2-3 glottic laryngeal carcinoma.Method:One hundred and twenty eight patients treated from 1999 to 2007 were selected from all glottic carcinoma patients with stage T2-3 in the first affiliated hospital,Dalian Medical University, who underwent surgery±radiation therapy.A retrospective review was randomized and matched by tumour subsite,TNM stage and age, which were confirmed by pathology and observation without thyroid perichondrium invaded or only local invasion of thyroid cartilage, there was no need to extensively resect laryngeal cartilages. Patients were divided into reserving thyroid partial laryngectomy group and other traditional partial laryngectomy group. Each group included 64 cases, which included T2N0 38 cases, T2N1 6 cases, T2N2 1 cases, T3N0 17 cases, T3N1 2 cases. Local control rate, decannulation rate, the 3-year and 5-year actuarial survival were compared between two treatment groups.Result: The 3-year and 5-year accumulative survival rate estimate were 89.8% and 84.3% in reserving thyroid partial laryngectomy,91.5% and 85.4% in other partial laryngectomy;local control rate estimate was 91.7 % in reserving thyroid partial laryngectomy and 93.2 % in other partial laryngectomy.There was no significant difference between the two treatment groups when comparing survival and local control rates (P> 0.05).Decannulation rate was 98.3% in reserving thyroid partial laryngectomy and 88.1 % in other partial laryngectomy.There were significant differences between the two treatment groups (P < 0.05).Conclusion:Comparing with other partial laryngectomy,reserving thyroid partial laryngectomy was successful for treating properly selected stage T2-3 glottic laryngeal carcinoma. This operation had higher decannulation rate and lower complication,which was effective for reducing surgical invasion and facilitated the resumption of respiratory.