[Surgical therapy of subglottic carcinoma]

To analyze the clinical characteristics, surgical procedures and correlated prognostic factors of the cases with subglottic carcinoma; to seek for the optimal surgical treatment for the patients suffering from subglottic carcinoma.

Twenty-four cases with subglottic carcinoma were retrospectively reviewed, the disease-free survival rates of the patients at 3 years were analyzed according to the different T N phases and the surgical modalities.

The free-disease survival rate at 3 years was 50.0% (12/24) for 24 cases with subglottic carcinoma. The survival rates of 19 cases with total laryngectomy was 47.4% (9/19), and the survival rates in T2, T3, T4 phases were respectively 1/1, 6/11, 2/7. The survival rates of 5 cases with partial laryngectomy was 3/5, the survival rates in T2, T3 phases were respectively 3/4, 0/1, and the surgical margins were verified to be positive in 2 of 5 cases being performed partial laryngectomy. The metastasis rate of lymph nodes was 33.3% (8/24). The survival rates of patients with N0, N1, N2 disease were respectively 10/16, 1/4, 1/4. The positive lymph nodes were verified in the neck regions of II-VI and superior mediastinum.

Prognoses of the cases with subglottic carcinoma were poor, early treatment could result in good effect. Until now total laryngectomy still the mainly treatment of subglottic carcinoma. Only the patients with earlier subglottic carcinoma are amenable to partial laryngectomy and should be given postoperative irradiation. Lymph node metastasis was a very important prognostic factor. Paratracheal lymph nodes are the sentinel nodes for subglottic carcinoma, and it is reasonable to probe the nodes. Once verifying positive lymph node, the typical neck dissection involving I-VI regions and superior mediastinum should be performed.