후두암 환자에 대한 치료성적과 예후인자

Treatment Results and Prognostic Factors in Laryngeal Cancer Patient

  • 송달원 (계명대학교 의과대학 이비인후과학교실) ;
  • 여창기 (계명대학교 의과대학 이비인후과학교실) ;
  • 송인혁 (계명대학교 의과대학 이비인후과학교실) ;
  • 남영진 (계명대학교 의과대학 이비인후과학교실) ;
  • 이준엽 (계명대학교 의과대학 이비인후과학교실) ;
  • 구민본 (계명대학교 의과대학 이비인후과학교실) ;
  • 남성일 (계명대학교 의과대학 이비인후과학교실) ;
  • 안병훈 (계명대학교 의과대학 이비인후과학교실)
  • Song, Dal-Won (Department of Otolaryngology, Keimyung University School of Medicine) ;
  • Yeo, Chang-Ki (Department of Otolaryngology, Keimyung University School of Medicine) ;
  • Song, In-Hyuk (Department of Otolaryngology, Keimyung University School of Medicine) ;
  • Nam, Young-Jin (Department of Otolaryngology, Keimyung University School of Medicine) ;
  • Lee, Jun-Yeop (Department of Otolaryngology, Keimyung University School of Medicine) ;
  • Koo, Min-Bon (Department of Otolaryngology, Keimyung University School of Medicine) ;
  • Nam, Sung-Il (Department of Otolaryngology, Keimyung University School of Medicine) ;
  • Ahn, Byung-Hoon (Department of Otolaryngology, Keimyung University School of Medicine)
  • 발행 : 2007.05.31

초록

Background and Objectives:The prevalence rate of laryngeal cancer, the cancer known as good prognosis in comparison to other malignancy, accounts for 1% of all malignancy in Korea(Korea Central Cancer Registry, 2002). The purpose of this study is to review the treatment experiences of our hospital and find prognostic factors in laryngeal cancer patients. Materials and Method:A retrospective study was conducted on 244 laryngeal cancer patients between January 1987 through December 2003. Age, sex, TNM stage, 5 year survival rate, prognostic factors were analyzed. Results:The overall 5 year survival rate was 57.8%. The 5 year survival rate according to primary site and treatment method showed supraglottis 49.5%, glottis 79.2%, transglottis 28.2% and surgery only 71.4%, radiotherapy only 58.1%, post operative radiotherapy 47.2%, salvage operation 52.0%. There was no statistically significant difference among the results obtained by 4 different methods of treatment. but in supraglottis, surgery only has good 5 year survival rate(75.8%) compare to radiotherapy only(38.3%), postoperative radiotherapy(20.0%), salvage operation(43.7%) and there was statistically significant difference. The 5 year survival rate according to clinical stage and T status showed 84.1%, 37.2%, in stage I & II, III & IV respectively, 72.9%, 37.5% in stage T1 & T2, T3 & T4 respectively. The 5 year survival rate according to nodal status showed N(-)77.1%, N(+)35.6%. Conclusion:Those patient with early T stage, early clinical stage, glottic cancer, negative neck node and surgery only patient in supraglottis showed good treatment results in univariate analysis. The clinical stage and primary site of laryngeal cancer were found to be significant prognostic factors in laryngeal cancer patients in multivariate analysis.

키워드

참고문헌

  1. Kim KM, Kim YM, Shin YS, et al: Epidemiologic survey of head and neck cancers in Korea. J Korean Med Sci. 2003;18:80-87 https://doi.org/10.3346/jkms.2003.18.1.80
  2. Hong WP, Kim YH, Choi EH, Kim KM: Clinical analysis on cancer of the larynx. Korean J Otolarngol. 1995;38:2024-2033
  3. Kim KM, Kim HY, Choi HS, et al: Experiences of the treatment of laryngeal cancer in Youndong severance hospital. Korean J Otolaryngol. 1998;41:518-522
  4. Kim KH, Sung MW, Chung JW, et al: Laryngeal cancer in korea: Epidemiological study. Korean J Otolaryngol. 1996;39:1577-1587
  5. Kim KH, Noh KT, Sung MW, Baek CH, Yoo YS: Treatment result of laryngeal cancer. Korean J Otolaryngol. 1988;31:783-791
  6. Shim YS, Yoo SY: Treatment result of the carcinoma of larynx. Korean J Otolaryngol. 1985;28:46-56
  7. Suh JS, Song SI, Kim JW, et al: A clinical study of the laryngeal cancer. Korean J Otolarygol. 1999;421:1015-1020
  8. Song DW, Kim HJ, Jeong HS, et al: Treatment result in laryngeal cancer patients submitted to surgical treatment. Korean J Otolaryngol. 1999;42:1284-1289
  9. Turcker HM: Conservation laryngeal surgery in the elderly patients. Laryngoscope. 1977;87:1995-1999
  10. Moon KG, Tae K, Kim KR, Lee HS, Ahn KS: Treatment result of laryngeal cancer. Korean J Otolaryngol. 1994;37(5):1059-1065
  11. Chung WK, Kim IH, Ahn SJ, et al: Investigation of Study Items for the Patterns of Care Study in the Radiotherapy of Laryngeal Cancer: Preliminary Results. J Korean Soc Ther Radiol Oncol. 2003; 21(4):299-305
  12. Vinventiis M, Minni A, Gallo A: Supracricoid laryngectomy with cricohyoidopexy(CHP) in the treatment of laryngeal cancer: A functional and oncologic experience. Laryngoscope. 1996;106: 1108-1114 https://doi.org/10.1097/00005537-199609000-00013
  13. Lee SY, Choi JO, Jung KY, Yoo HK: The Results of conservation surgery in laryngeal cancer. Korean J Head Neck Oncol. 1991;7: 17-23
  14. Weber RS, Forastiere A, Rosenthal DI, Laccourreye O: Controversies in the management of advanced laryngeal squamous cell carcinoma. Cancer. 2004;101(2):211-219 https://doi.org/10.1002/cncr.20231
  15. Yao M, Epstein JB, Modi BJ, Pytynia KB, Mundt AJ, Feldman LE: Current surgical treatment of squamouscell carcinoma of the head and neck. Oral Oncology. 2007;43:213-223 https://doi.org/10.1016/j.oraloncology.2006.04.013
  16. Till JE, Bruce WR, Elwan A, et al: A preliminary analysis of end results for cancer of the larynx. Laryngoscope. 1975;85:259-275 https://doi.org/10.1288/00005537-197502000-00003
  17. Lee JD, Lee KD, Lee WJ, et al: A clinical study on the laryngeal cancer. Clin Otol. 1995;6:69-76
  18. Murray JD, Carison GW, Mclaughlin K, et al: Tumor angiogenesis as a prognostic factor in laryngeal cancer. Am J Surg. 1997; 174:523-526 https://doi.org/10.1016/S0002-9610(97)00168-2
  19. Nguyen-tan PF, Le QY, Quivey JM, et al: Treatment results and prognostic factors of advanced T3-4 laryngeal carcinoma: the university of California, Sanfrancisco(UCSF) and stanford university hospital(SUH) experience. Int J Radiat Oncol Biol Phys. 2001;50:1172-1180 https://doi.org/10.1016/S0360-3016(01)01538-3