ABSTRACT
In the period from 1976 to 1988, 417 patients with supraglottic carcinoma of the larynx were treated by primary surgery. Infiltration of the pre-epiglottic space was found in 11.99 per cent (50/417) of the patients. Carcinomas of the infrahyoid epiglottis spread to this space more frequently--14.24 per cent (44/309), than those of suprahyoid localization--5.55 per cent (6/108). Tumour invasion of the pre-epiglottic space is a relative contra-indication for reconstructive surgery. Partial conservation operations were performed on 32 per cent (16/50) of patients with invasion of the pre-epiglottic space. The remaining patients had a total laryngectomy. Infiltration of the paraglottic space intra-operatively was found in 2.4 per cent (10/417) of patients and all of these tumours were from the infrahyoid localization. Spread of tumours to this site is an indication for radical surgery and laryngectomy was performed on 80 per cent (8/10) of patients.
Subject(s)
Carcinoma/surgery , Laryngeal Neoplasms/surgery , Carcinoma/pathology , Epiglottis/pathology , Glottis/pathology , Humans , Laryngeal Neoplasms/pathology , Laryngectomy , Laryngostenosis/etiology , Neoplasm Recurrence, Local , Postoperative Complications/etiology , Tracheal Stenosis/etiologyABSTRACT
302 patients with planocellular larynx carcinoma treated by total laryngectomy during the period from 1975 to 1986 were analyzed. In the examined group of patients significant risk factors in tracheostoma relapse appearance were the next: glottis-subglottis tumor localization and regionally spread tumor. Planned postoperative radiotherapy can significantly reduce the risk of tracheostoma local relapses' appearance.
Subject(s)
Carcinoma, Squamous Cell/surgery , Laryngeal Neoplasms/surgery , Neoplasm Recurrence, Local , Tracheostomy , Carcinoma, Squamous Cell/pathology , Humans , Laryngeal Neoplasms/pathology , LaryngectomyABSTRACT
Undifferentiated nasopharyngeal carcinoma has been related to the Epstein-Barr virus. These tumors are known to be radiosensitive and chemosensitive. While radiotherapy (RT) allows for a high rate of local control, 80% of all patients die from or with metastatic spread. This study analyzed 61 patients treated with RT alone and 28 treated with zorubicin (ZRB)-cisplatin (CDDP) and RT between 1977 and 1990. All patients treated with RT received 60-74 Gy in 6-7 weeks. Patients treated with combined therapy received ZRB 250 mg/m2 on the 1st day and CDDP 30 mg/m2 from the 2nd to 5th day. The interval between cycles was 4 weeks. Following treatment with chemotherapy patients were then given RT. The 5-year survival rate was 20% for patients with T1 and T2 tumors when treated with RT alone and 54% when treated with chemotherapy (CT). This was 25% for T3 and T4 lesions with RT only and 27% for RT with CT. Survival of patients with N0 and N1 lesions was 41% after RT and 60% after RT with CT. This decreased to 10% for N2 and N3 lesions treated with RT and 30% with RT and CT.
Subject(s)
Antibiotics, Antineoplastic/administration & dosage , Antineoplastic Agents/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma/radiotherapy , Cisplatin/administration & dosage , Daunorubicin/analogs & derivatives , Nasopharyngeal Neoplasms/radiotherapy , Adult , Aged , Carcinoma/drug therapy , Carcinoma/secondary , Carcinoma/virology , Combined Modality Therapy , Daunorubicin/administration & dosage , Drug Administration Schedule , Female , Herpesviridae Infections/drug therapy , Herpesviridae Infections/radiotherapy , Herpesvirus 4, Human , Humans , Male , Middle Aged , Nasopharyngeal Neoplasms/drug therapy , Nasopharyngeal Neoplasms/virology , Neoplasm Recurrence, Local , Neoplasm Staging , Radiotherapy Dosage , Survival Rate , Tumor Virus Infections/drug therapy , Tumor Virus Infections/radiotherapyABSTRACT
One hundred and sixty-one patients with a supraglottic laryngeal carcinoma and clinically negative neck were studied. All patients had primary surgery and occult cervical node metastases were found in 18% (29/161). Local dissemination of tumour in the epilarynx did not influence the incidence of occult metastases, while the incidence of occult metastases increased with the degree of local spread in the supraglottis excluding the epilarynx. Ipsilateral occult metastases were more common (76%, 22/29), but both bilateral and contralateral spread was also seen (14%, 4/29 and 10%, 3/29, respectively).