70岁以上老年人喉癌发病特点及预后

发布时间：2019-01-22 11:54

【摘要】：目的：对70岁以上喉癌患者的发病特点及预后进行探讨。方法：对2006年10月到2008年10月复旦大学附属眼耳鼻喉科收治的70岁以上喉癌病例共155例,进行回顾和随访,总结其发病特点,治疗方式和预后。结果：全组患者共155人,平均年龄75.7±4.8岁,男女比例24.8：1。发病时间1月-600个月,中位时间4月。声门型116人,声门上型31人,跨声门型8人。临床分期：1、2期98人,3、4期56人。术前合并症：高血压50人(32.3%),心律失常11人(7.1%),冠心病5人(3.2%),慢性阻塞性肺病6人(3.9%),陈旧性肺结核、支扩、哮喘、肺癌术后等其他呼吸系统疾病4人(2.6%),糖尿病11人(7.1%),贫血1人(0.6%)。治疗方式：根治性放疗13例(8.4%),显微喉镜+激光14例(11.5%),部分喉切除术40例(32.8%),全喉切除术51例(54.1%),全喉或部分喉切除术+颈淋巴结清扫17例(13.9%),姑息手术或未治20例(12.9%),和全年龄组比较存在统计学差异(P0.05)。随年龄增长,患者接受姑息治疗和主动放弃治疗的比例增高(P0.05)。术后并发症与患者术前合并症相关。术后一年生存率94.5%,三年生存率76.2%。术后局部复发14人(10.9%),颈部淋巴结转移9人(7.0%),远处转移6人(4.7%),与全年龄组比较无统计学差异(P0.05)。结论：老年喉癌患者术前合并症发生率较高,术后并发症的发生与术前合并症相关。80岁以上高龄老人晚期喉癌得到根治性手术的机率低。接受合适的治疗后,老年喉癌患者的治疗效果和全年龄组相同。
[Abstract]:Objective: to investigate the characteristics and prognosis of laryngeal carcinoma over 70 years old. Methods: from October 2006 to October 2008 155 cases of laryngeal cancer over 70 years old admitted to the Department of Ophthalmolaryngology of Fudan University were reviewed and followed up. Results: there were 155 patients in the whole group, the average age was 75.7 卤4.8 years old, the ratio of male and female was 24.8: 1. The onset time was 1 month-600 months and the median time was 4 months. There were 116 glottic type, 31 supraglottic type and 8 transglottic type. Clinical stage: 1 98 patients with stage 2 and 56 patients with stage 3 or 4. Preoperative complications included hypertension in 50 patients (32.3%), arrhythmia in 11 patients (7.1%), coronary heart disease in 5 patients (3.2%), chronic obstructive pulmonary disease in 6 patients (3.9%), old pulmonary tuberculosis, bronchiectasis and asthma. Other respiratory diseases such as lung cancer were found in 4 cases (2.6%), diabetes in 11 cases (7.1%) and anemia in 1 case (0.6%). There were 13 cases (8.4%) of radical radiotherapy, 14 cases (11.5%) of microlaryngoscope laser, 40 cases (32.8%) of partial laryngectomy, 51 cases (54.1%) of total laryngectomy. Total laryngectomy or partial laryngectomy neck lymph node dissection in 17 cases (13.9%), palliative operation or untreated 20 cases (12.9%), compared with the whole age group there was statistical difference (P0.05). The proportion of patients receiving palliative treatment and voluntary abandonment increased with age (P0.05). Postoperative complications were associated with preoperative complications. The 1-year survival rate was 94. 5% and the 3-year survival rate was 76. 2%. Local recurrence was found in 14 cases (10.9%), cervical lymph node metastasis in 9 cases (7.0%) and distant metastasis in 6 cases (4.7%). There was no significant difference compared with the whole age group (P0.05). Conclusion: the incidence of preoperative complications in elderly patients with laryngeal carcinoma is high, and the incidence of postoperative complications is related to preoperative complications, and the probability of radical surgery for advanced laryngeal cancer in the elderly aged over 80 years is low. After appropriate treatment, elderly patients with laryngeal cancer had the same effect as all age groups.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R739.65

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