老年患者下咽肿瘤经口二氧化碳激光显微手术的肿瘤学结局与治疗可行性：一项回顾性队列研究
Oncologic Outcomes and Treatment Feasibility of Transoral Carbon Dioxide Laser Microsurgery for Hypopharyngeal Tumors in Older Patients: A Retrospective Cohort Study.
文献信息
| PMID | 42908194 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Takeharu Ono |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan. |
| 期刊 | Head & neck |
| SCI 分区 | Q1 |
| IF | 2.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 我们评估了经口CO2激光显微手术（TLM）治疗下咽肿瘤的结局和并发症，以及其在≥75岁患者中的可行性。
方法： 我们回顾性分析了2012年2月至2024年10月在本院接受治疗的116例患者（无转移）。采用Kaplan-Meier曲线分析肿瘤学结局（110例患者；中位随访时间：5.3年）。
结果： 5年局部控制率、疾病特异性生存率和总生存率分别为87.8%、94.6%和85.6%。术后吞咽困难、吸入性肺炎、咽喉水肿和声带麻痹的发生率分别为9%、4%、3%和3%；无一例需要气管切开或全身麻醉下手术止血。有头颈部放疗史组的吞咽困难（p = 0.010）和吸入性肺炎（p = 0.031）发生率高于无放疗史组。年龄组间差异无统计学意义。
结论： 对于经过适当选择的下咽肿瘤老年患者，TLM似乎是安全有效的。
英文摘要
BACKGROUND: We evaluated outcomes and complications of transoral CO2 laser microsurgery (TLM) for hypopharyngeal tumors and its feasibility in ≥ 75-year-old patients.
METHODS: We retrospectively reviewed 116 patients (without metastases) treated from February 2012 to October 2024 at our hospital. Oncologic outcomes were analyzed using Kaplan-Meier curves (110 patients; median follow-up: 5.3 years).
RESULTS: Five-year local control, disease-specific survival, and overall survival rates were 87.8%, 94.6%, and 85.6%, respectively. Postoperative dysphagia, aspiration pneumonia, pharyngolaryngeal edema, and vocal fold paralysis occurred in 9%, 4%, 3%, and 3% of patients, respectively; none required tracheostomy or surgical hemostasis under general anesthesia. The group with a history of head and neck irradiation had higher rates of dysphagia (p = 0.010) and aspiration pneumonia (p = 0.031) than those without. Differences between age groups were nonsignificant.
CONCLUSIONS: TLM appears safe and effective for older patients with appropriately selected hypopharyngeal tumors.