喉頭癌に対する喉頭部分切除術の適応

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  • Indication of Partial Laryngectomy for Laryngeal Carcinoma

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Between 1975 and 1992, 20 patients with squamous cell carcinoma of the larynx (10 supraglottic, 9 glottic, 1 subglottic lesion) underwent partial laryngectomy at the Dokkyo University School of Medicine.<BR>Eleven patients had a lesion of Stage I or II and nine were of Stage III. Of the 11 patients with Stage I or II, seven were radiation failure cases, two could not complete radiotherapy and two underwent partial laryngectomy as the initial treatment. For the nine patients with Stage III lesions, preoperative rediation was employed in five cases, postoperative radiation was given to three and no radiotherapy was combined in one. The 5 year cumulative survival rate was 40% in supraglottic carcinomas and 88% in glottic carcinomas. It did not differ among the stages. We conclude that indications of partial laryngectomy are residual or recurrent glottic T1 and T2 lesions after radiotherapy and selected glottic T3 carcinomas. The criteria of partial laryngectomy for glottic T3 carcinomas are as follows : (1) fixation of the vocal fold due to vocalis muscle involvement without cricoarytenoid joint invasion; (2) localized paraglottic space involvement without transglottic extension and (3) no neck metastasis.

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