喉部肉瘤的临床病理特征及预后

金晓峰; 陈兴明; 李五一; 彭培宏; 姜鸿; 祝小莉; 曹克利; 张宝泉; 张连山; 高志强

doi:10.3969/j.issn.1674-9081.2012.02.009

喉部肉瘤的临床病理特征及预后

Clinical and Pathological Characteristics and Treatment Outcome of Sarcoma of the Larynx

摘要

摘要:
目的探讨喉部肉瘤的临床病理特征及其预后影响因素。
方法回顾性分析北京协和医院耳鼻咽喉科1990年1月至2008年12月期间住院治疗的13例喉部肉瘤患者的临床资料, 分析肿瘤的临床病理特性, 以Kaplan-Meier法进行生存率统计并分析临床分期和组织学分级与生存率的关系。
结果喉部肉瘤患者以男性为主(9/13), 含7种病理类型:恶性纤维组织细胞瘤、平滑肌肉瘤、横纹肌肉瘤、滑膜肉瘤、软骨肉瘤、神经纤维肉瘤、癌肉瘤。12例接受手术治疗, 其中7例术后进行了放疗和/或化疗; 另1例仅行放疗。全部病例平均随访29.3个月, 其中5例出现局部复发, 1例出现远处转移, 5年生存率为38.0%。临床分期和组织学分级对生存率有明显影响(P < 0.05)。
结论喉部肉瘤预后差, 临床分期和组织学分级与预后相关。

Abstract:
Objective To determine the clinical and pathological characteristics as well as outcome of sarcoma of the larynx.
Methods A retrospective review of 13 patients with laryngeal sarcoma treated in Peking Union Medical College Hospital from January 1990 to December 2008 was taken to identify clinical characteristics, pathological characteristics, and therapeutic modalities. Kaplan-Meier survivals were compared according to T-stage and histological G-grade.
Results Sarcoma of the larynx showed a male predominance in all cases (9/13) and presented 7 pathological types:maglignant fibrous histiocytoma, leiomyosarcoma, rhabdomyosarcoma, synovial sarcoma, chondrosarcoma, neurofibrosarcoma, carcinosarcoma. Twelve cases underwent tumor resection, including partial laryngectomy, total laryngectomy, and endoscopic resection. Among them, 7 cases underwent postoperative radiological therapy and/or chemical therapy. Another case only received radiological therapy. The average follow up time of all cases was 29.3 months and five-year survival rate was 38.0%. Local recurrence occurred in 5 cases and distant metastasis in 1 case. Survival rate was significantly different according to T-stage and histological G-grade (log-rank, P < 0.05).
Conclusions Sarcomas of the larynx show poor prognosis. The factors influencing survival rate include T-stage and G-grade.

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