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目的:探讨老龄喉癌患者手术疗效及预后因素。方法:≥65岁的喉癌患者110例中,行喉部分切除术62例,喉全切除环咽吻合术(Arslan术)8例,喉全切除术40例。53例联合放疗及化疗。结果:4例失访,5、10年生存率分别为66.6%和44.2%;5、10年无瘤生存率分别为57.0%和38.4%,中位生存期84个月。拔管率87.1%。单因素分析组织学分级、治疗模式、淋巴结转移、原发部位不同组间生存分布的差异具有统计学意义(P<0.01);肿瘤分期、手术方式、复发、性别不同组间生存分布的差异具有统计学意义(P<0.05)。多因素分析组织学分级及治疗模式对本组患者生存率影响较大,分化程度低及综合治疗者生存期短。结论:喉功能保全性手术是治疗老龄喉癌患者的有效方法;综合治疗者预后差,不适用于切缘阴性者。
Objective: To investigate the surgical efficacy and prognosis of elderly patients with laryngeal cancer. Methods: Among the 110 cases of laryngeal cancer ≥65 years, 62 cases underwent partial laryngectomy, 8 cases underwent total laryngectomy and Arslanctomy, and 40 cases underwent total laryngectomy. 53 cases of combined radiotherapy and chemotherapy. Results: The 4 patients were lost to follow-up. The 5-year and 10-year survival rates were 66.6% and 44.2% respectively. The 5-year and 10-year disease-free survival rates were 57.0% and 38.4%, respectively. The median survival time was 84 months. Extubation rate of 87.1%. Univariate analysis showed statistically significant differences in survival distribution between histological grading, treatment modalities, lymph node metastasis and primary site (P <0.01). The differences in survival distribution between tumor groups, surgical methods, relapse, and gender were statistically significant Statistical significance (P <0.05). Multivariate analysis of histological grade and treatment model of the survival rate of patients with a greater impact on the low degree of differentiation and comprehensive treatment of patients with short survival. CONCLUSION: Laryngeal preserving surgery is an effective method for the treatment of elderly patients with laryngeal cancer. The comprehensive treatment of patients with poor prognosis does not apply to those with negative margins.