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Updated: Oct 15, 2026

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Learning Modern Laryngeal Surgery in a Dissection Laboratory
Published on: March 18, 2020
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常规后续检查的价值,以检测喉状细胞癌的治愈意图治疗后的复发情况
Cecile van de Weerd1, Sandra M E Geurts2, Richard J M T Vercoulen1
1Radboud University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands.
概括
喉平细胞癌 (LSCC) 的例行随访对早期疾病可能不那么有益. 对于高级的LSCC,重点应该转向治疗后的心理社会支持,因为无症状复发的常规检测有限.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 在瘤学瘤学.
- 头部和部手术 头部和部手术
背景情况:
- 喉状细胞癌 (LSCC) 常规随访方案的有效性仍在争论中,对特定患者亚组的证据有限.
- 目前的全球指南是基于共识的,需要进一步研究最佳后续策略.
研究的目的:
- 评估包括灵活内镜在内的常规随访在初级LSCC治疗后检测局部区域复发 (LRR) 的有用性.
- 分析常规随访对LRR检测,治疗意图和按疾病阶段分层的整体生存 (OS) 的影响.
主要方法:
- 在2006年至2012年期间治疗的413名LSCC患者的回顾性分析.
- 累计LRR风险的计算和检测时间的评估 (常规与间隔).
- 根据早期 (TNM I-II 阶段) 和晚期 (TNM III-IV 阶段) 的疾病阶段对分析进行分层.
主要成果:
- 早期的LSCC (n=263) 的1年,2年和5年的LRR风险分别为8%,18%和26%. 晚期LSCC (n=132) 的风险分别为20%,30%和35%.
- 对于早期的LSCC,72%的LRR被常规检测出来,81%是有症状的. 五年后的OS对于常规检测 (70%) 和间隔检测 (72%) 的复发是相似的.
- 对于晚期的LSCC,42%的LRR是常规检测的,84%是症状性的. 在常规检测的 (37%) 与间隔检测的 (18%) 复发中,五年后的生存率更高,尽管在统计学上并不显著 (p=0.06).
结论:
- 在早期的LSCC中,检测无症状复发的例行随访似乎是多余的.
- 在晚期LSCC中,尽管进行例行监测,但在治疗后一年内没有检测到无症状复发.
- 晚期LSCC的治疗后随访应优先考虑心理社会支持,特别是在第一年之后,而不是仅专注于复发检测.
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