The impact of preoperative tracheotomy on T3 transglottic carcinomas of the larynx.
Eur Arch Otorhinolaryngol
; 256(2): 78-82, 1999.
Article
em En
| MEDLINE
| ID: mdl-10068895
To evaluate the impact of the practice of a preoperative tracheotomy and different prognostic factors reported in the literature in patients with transglottic carcinoma of the larynx, a retrospective study was performed in the Instituto Nacional de Cancerologia, Mexico City. In all, 90 cases with T3 transglottic squamous cell carcinoma requiring a total laryngectomy as primary treatment were studied. Prognostic factors such as the Karnofsky index, tumor differentiation, surgical margins and preoperative tracheotomy were analyzed by a Cox's proportional hazards model. The Kaplan-Meier method and log rank test were used to evaluate the disease-free intervals and survival curves. Thirty-two patients had preoperative tracheotomies, while 58 did not. Eighty percent of the patients in the non-preoperative tracheotomy group were alive after 5 years versus 20% of those with preoperative tracheotomies (P < 0.001). Although possibly controversial, our findings indicate that a pretreatment tracheotomy should be avoided in T3 transglottic obstructive lesions. In patients with these lesions and a subglottic extension < or = 3 cm we recommend an emergency total laryngectomy when possible to increase survival and decrease surgical morbidity.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidados Pré-Operatórios
/
Traqueostomia
/
Carcinoma de Células Escamosas
/
Neoplasias Laríngeas
/
Glote
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Eur Arch Otorhinolaryngol
Assunto da revista:
OTORRINOLARINGOLOGIA
Ano de publicação:
1999
Tipo de documento:
Article
País de afiliação:
México
País de publicação:
Alemanha