Tuncay TUNÇCAN, Caner KILIÇ, Arzubetül DURAN, Samet ÖZLÜGEDİK, Bayram BÜYÜK

Total Larenjektomi Vakalarımızın Analizi

Amaç: Primer ve nüks ileri evre larinks tümörlerinde veri ve tecrübelerimizi paylaşmak. Gereç ve Yöntem: 2012-2019 yılları arasında kliniğimizde skuamöz hücreli larinks tümörü tanılı primer ve radyoterapi sonrası nüks nedeniyle total larenjektomi operasyonu geçiren hastaların kayıtları retrospektif olarak incelendi. Bu incelemede; hastalar yaş, cinsiyet, T evresi, primer yerleşim yeri, transglottik uzanım, lenf nodu metastazı, ekstrakapsüller yayılım, cerrahiye tiroid bez eksizyonunun eklenmesi ve 5 yıllık hastalıksız sağ kalıma göre tarandı. Bulgular: Altmışı (%74) primer, 21’i (%26) radyoterapi sonrası nüks olmak üzere toplam 81 hastaya total larenjektomi uygulandı. Primer hastaların 18’inde metastatik lenf nodu izlendi.15 hastaya tiroid lobektomi, 7 hastaya total tiroidektomi eklenmişti. Primer hastalarda 5 yıllık hastalıksız sağ kalım %58.3 iken kurtarma cerrahisi yapılan hastalarda %52.9 idi. Sonuç: Radyoterapi nüksü sonrası total larenjektomi yapılması, primer hastalara göre ek komorbiditelere neden olabilmektedir. Tedavi için cerrahi yada radyoterapi kararı verilirken radyoterapinin mevcut beklenen yan etkileri dışında olası nüks ve bu nüksler nedeniyle gerekebilecek sekonder cerrahiler hakkında bilgi verilerek nihai kararın hastalarla birlikte kararlaştırılması gerekliliğini düşünmekteyiz.

Analysıs of Total Laryngectomy Cases

Objective: To share our data and experiences of the primary and recurrent advanced larynx tumors. Material and Method: Recordings of patients which have undergone total laryngectomy between 2012-2019, for reccurence after primary radiothe-rapy is reviewed retrospectively. Patients were reviewed for age, gender, T stage, primary site of disease, transglottic extension, lymph node metasta-sis, extracapsular extension, whether thyroid gland excision is done and 5-year disease free survival rate. Results: Total laryngectomy is done in 81 patients of whom 60 (74%) were primary and 21 (26%) were recurrence cases after radiotherapy. Eighteen of the primary patients had metastatic lymph nodes, 15 patients had thyroid lobectomy and 7 patients had total thyroidectomy. The 5-years disease-free survival rates were 58.3% in primary patients and 52.9% in salvage patients. Conclusion: Performing total laryngectomy after radiotherapy recurrence may cause additional comorbidities in the patient compared to the primary patients. We are in the consideration that, when making a choose between surgery and radiotherapy, the final decision should be made with patients by informing them about possible recurrences and secondary surgeries due to these recurrences in addition to the side effects of radiotherapy.

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