Burak ERDAMAR, Yusufhan SÜOĞLU, Haluk EMİN, Kamil AKDAĞ, Erkan KIYAK, Tayfun SUNAY, İsmail ÇÖLHAN

Primer subglottik larenks kanseri

Amaç : Larenksin primer olarak subglottik bölgesindenkaynaklanan tümörler seyrek görülür. Bu çalıflmada,primer subglottik kanserli hastalar ile ilgili gözlemlerimizi ve izlem sonuçlarımızı sunmayı amaçladık.Hastalar ve Yöntemler: Primer subglottik tümör nedeniyle tedavi edilen 15 hasta incelendi. Hastaların, üçyıllık sağkalım oranları hesaplandı; Kaplan-Meieryaflam eğrileri çıkarıldı ve farklı klinik parametrelerinbu değerler üzerindeki olası etkileri arafltırıldı. Bulgular: Tanı aflamasında tümör evreleri iki hastada %14 T1, befl hastada %33 T2, üç hastada %20 T3,befl hastada %33 T4fleklindeydi. Üç yıl sonunda sağkalım oranı %73.4 11/15 bulundu. Kaplan-Meier yöntemi ile hesaplanan medyan yaflam süresi 45 ay idi.Ekstralarenjeal uzanımı olan hastaların yaflam süreleriile, larenkse sınırlı hastalık nedeniyle tedavi edilen olgular arasında anlamlı bir fark gözlenmedi. Sonuç: Primer subglottik larenks kanseri, lokal olarak agresif seyirli olmasına ve tanı anında larenksdıflına yayılım olasılığı yüksek bulunmasına rağmen,uygun tedavi yönteminin seçimiyle yüksek sağkalımoranları elde edilebilir

Anahtar Kelimeler:

Karsinom/skuamöz hücreli/cerrahi/radyoterapi, kombine tedavi, glottis, larenjeal neoplazmlar/cerrahi/radyoterapi, larenjektomi, sağkalım oranı

Primary carcinoma of the subglottic larynx

Objectives: Primary carcinoma of the subglottic lar- ynx is very rare. This study was designed to evalu- ate patients who were treated for primary carcinoma of the subglottic larynx.Patients and Methods: The study included 15 patients 14 men, 1 woman; mean age 62.8 years; range 45 to 95 years with primary subglottic carci noma. Correlations of different clinical parameters with three-year survival rate and Kaplan-Meier sur- vival analysis were investigated.Results: On presentation, two patients 14% had Ti, five patients 33% had T2, three patients 20% had T3, and five patients 33% had T4 tumors. The overall three-year survival rate was 73.4% 11/15 .The median survival calculated by the Kaplan-Meier method was 45 months. No significant differences were found between the survival rates of patients with and without extralaryngeal extension.Conclusion: Although primary subglottic cancer is locally aggressive with high tendency to extend to the extralaryngeal compartment at the time of diagnosis, high survival rates can be expected when appropriate treatment modalities are selected.

Keywords:

Carcinoma squamous cell/surgery/radiotherapy, combined modality therapy, glottis, laryngeal neoplasms/surgery/radiotherapy, laryngectomy, survival rate,

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Dahm JD, Sessions DG, Paniello RC, Harvey J. Primary subglottic cancer. Laryngoscope 1998;108:741-6.
Sessions DG, Ogura JH, Fried MP. Carcinoma of the subglottic area. Laryngoscope 1975;85:1417-23.
Ferlito A, Rinaldo A. The pathology and management of subglottic cancer. Eur Arch Otorhinolaryngol 2000; 257:168-73.
Santoro R, Turelli M, Polli G. Primary carcinoma of the subglottic larynx. Eur Arch Otorhinolaryngol 2000; 257:548-51.
Vermund H. Role of radiotherapy in cancer of the lar- ynx as related to the TNM system of staging. A review. Cancer 1970;25:485-504.
Lederman M. Radiotherapy of cancer of the larynx. J Laryngol Otol 1970;84:867-96.
McGavran M, Bauer W, Ogura J. The incidence of cervi- cal lymphe node metastasis from epidermoid carc i n o m a of the larynx and their relationship to certain character- istics of the primary tumor. Cancer 1961;14:55-66.
Harrison DF. The pathology and management of sub- glottic cancer. Ann Otol Rhinol Laryngol 1971;80:6-12.
Beahrs OH. The larynx. In: Beahrs OH, editor. Manual for staging cancer of the American Joint Committee on Cancer. 4th ed. Philadelphia: J.B. Lippincott; 1992. p. 39-41.
Muntz H, Sessions D. Surgery of the laryngopharyn- geal and subglottic cancer. In: Bailey BJ, editor. Surgery of the larynx. 1st ed. Philadelphia: W.B. Saunders; 1985. p. 311-4.
Lund WS. Classification of subglottic tumors and dis- cussion of their growth and spread. Can J Otolaryngol 1974;3:469-72.
Kirchner JA. One hundred laryngeal cancers studied by serial section. Ann Otol Rhinol Laryngol 1969;78: 689-709.
Haylock BJ, Deutsch GP. Primary radiotherapy for subglottic carcinoma. Clin Oncol (R Coll Radiol) 1993; 5:143-6.
Pietrantoni L, Agazzi C, Fior R. Indications for surgical treatment of cervical lymph nodes in cancer of the lar- ynx and hypopharynx. Laryngoscope 1962;72:1511-27.
Thaler ER, Montone K, Tucker J, Weinstein GS. Delphian lymph node in laryngeal carcinoma: a whole organ study. Laryngoscope 1997;107:332-4.
Hosal IN, Onerci M, Turan E. Peristomal recurrence. Am J Otolaryngol 1993;14:206-8.