Analysis Of Curative Effect And Prognostic Factors Of Open Surgery And Radiotherapy For Early Glottic Carcinoma

ObjectivesThe curative effects of two methods(surgery and radiotherapy)in the treatment of early glottic carcinoma were compared,and the prognostic factors were analyzed to provide reference for clinical treatment.MethodsA total of 69 patients with early glottic carcinoma(Tis,T1,T2)treated in the Department of head and neck surgery and Oncology radiotherapy,the first affiliated Hospital of Kunming Medical University from 2005 to 2014,43 of them underwent partial laryngectomy(operation group).26 patients were treated with radiotherapy(radiotherapy group).The 5-year disease-free survival rate,3-year survival rate,5-year local control rate,incidence of postoperative complications and effective rate of laryngeal function improvement were compared between the two groups.Sex,age,smoking,drinking,tumor differentiation,tumor T stage,tumor location and vocal cord activity were used as observation indexes to analyze the prognostic factors.Results1.3,5-year survival rate,5-year disease-free survival rate and 5-year local control rate.The 3-year survival rates of surgery group and radiotherapy group were 93.0%and 88.5%,respectively(x 2=0.04,P>0.05).The 5-year survival rates of operation group and radiotherapy group were 90.7%and 80.8%,respectively(x 2=0.67,P>0.05).There were 6 cases of local recurrence in the operation group,1 case of distant metastasis and 6 cases of local recurrence in the radiotherapy group.The 5-year disease-free survival rates of the two groups were 83.7%and 76.9%,respectively(x 2=0.15,).P>0.05).The 5-year local control rates in surgery group and radiotherapy group were 80.6%and 76.9%,respectively(x 2=0.41,P>0.05).3,5-year survival rate,5-year disease-free survival rate and 5-year local control rate were not statistically significant.2.Complications and effective rate of improvement of laryngeal function.The incidence of complications was 11.6%in the operation group and 38.5%in the radiotherapy group.The comparison of complications between the two groups was statistically significant(P<0.05).The effective rate of laryngeal function improvement was 32.6%in operation group and 84.6%in radiotherapy group.There was statistical significance(P<0.05).3.Analysis of prognostic factors.Univariate analysis showed that the main factors affecting prognosis were limitation of vocal cord activity,T stage and degree of differentiation.Multivariate Logistic regression analysis showed that the main factors afecting prognosis were T stage and degree of differentiation.Conclusions1.There was no significant difference between the operation group and the radiotherapy group in the treatment of early glottic carcinoma,and there was no significant difference in 3-and 5-year overall survival rate,5-year disease-free survival rate and 5-year local control rate between the two groups(P>0.05).2.The incidence of complications in operation group and radiotherapy group was 11.6%and 38.5%respectively(P<0.05).The effective rate of laryngeal function improvement in operation group and radiotherapy group was 32.6%and 84.6%respectively(P<0.05).The incidence of complications in the operation group was significantly lower than that in the radiotherapy group,and the improvement rate of laryngeal function in the radiotherapy group was better than that in the operation group.The two methods for the treatment of early glottic carcinoma have their own advantages.3.Univariate analysis showed that the main factors affecting prognosis were limitation of vocal cord activity,T stage and degree of differentiation.Multivariate Logistic regression analysis showed that the main factors affecting prognosis were T stage and degree of differentiation.We can draw a conclusion that the key to the treatment of early glottic carcinoma is early diagnosis and early treatment.