Wyniki radykalnego leczenia chirurgicznego 355 chorych z zaawansowanym rakiem krtani

Abstract Introduction The aim of the study was to evaluate the results of radical surgery in group of 355 patients with advanced laryngeal cancer. Material and method The paper presents results of treatment in group of 355 patients with advanced laryngeal cancer treated in the ENT Clinical Department in Zabrze in the following years 1998–2007. The advancement stage was defined as III in 147 patients (42%), as IV in 208 patients (58%). Group of 250 patients (70%) underwent total laryngectomy and group of 105 patients (30%) underwent pharyngolaryngectomy. In the group of 327 patients (92%) operation was performed microscopically radically. 298 patients (84%) underwent postoperative radiotherapy. Median follow-up period was 5 years. Local recurrence, nodal recurrence and distant metastasis were rated as treatment failure. Treatment effectiveness was evaluated in relation to overall survival, disease-free survival, local control, locoregional control and observation free from metastases. All of these parameters were analyzed with the method of updated percentages. Results During observation period 177 patients (50%) died. Local recurrence occurred in 47 patients (13%), nodal recurrence occurred in 19 patients (5%). Distant metastases occurred in 26 patients (7%). 5-year overall survival rate (OS) was 50%. 5-year disease-free survival rate (DFS) was 47%. 5-year local control rate (LC) was 81%. 5-year locoregional control rate (LRC) was 75%. The updated 5-year observation free from metastases rate (FFM) was 89% respectively. Conclusion Radical surgery is the chance of 5-year survival of 50% of patients with advanced cancer of the larynx and of 5-year locoregional control of 75% patients.