早期声门型喉癌内镜手术疗效及预后分析:单中心151例回顾性研究OA

Objective:To evaluate the clinical efficacy of endoscopic surgery for early glottic laryngeal cancer(EGLC)and analyze the factors influencing prognosis.Methods:A retrospective analysis was performed on 151 patients diagnosed with EGLC who underwent endoscopic CO2 laser microsurgery or low-temperature plasma radiofrequency ablation at the De-partment of Otorhinolaryngology,Suining Central Hospital,between January 2016 and December 2024.Patient demographic and clinical data were retrospectively collected,and postoperative follow-up was conducted.Overall survival(OS)and dis-ease-free survival(DFS)rates were estimated using the Kaplan-Meier method.We used a Cox proportional hazards regression model to identify predictors of OS and DFS.Re-sults:There were 21 cases of recurrence,with a recurrence rate of 13.9%.Significant differences in recurrence rate were observed among patients with different clinical stages(χ2=31.838,P<0.001),with the highest rate of 63.6%(7/11)in the T2 stage.Recurrence rate also differed significantly by tumor differentiation grade(χ2=24.298,P<0.001),with the highest rate of 71.4%(5/7)in the poorly differentiated group.The 1-,2-,and 3-year DFS rates were 99.3%,87.3%,and 84.0%,respectively;the corresponding OS rates were 99.3%,98.4%,and 96.7%.Multivariate Cox regression analy-sis identified clinical stage and tumor differentiation as independent predictors of postoperative recurrence in EGLC patients.Specifically,patients with T2 stage had a higher risk of recurrence compared to those with Tis stage(RR=3.088,95%CI:1.245～7.611,P=0.015).Similarly,patients with poorly differentiated tumors had a higher risk of postoperative recur-rence compared to those with in situ cancer(RR=3.052,95%CI:1.319～7.060,P=0.009).Conclusion:Treat-ment of EGLC with CO2 laser or low-temperature plasma radiofrequency ablation under laryngoscopy is effective and associat-ed with favorable patient prognosis.Both clinical stage and tumor differentiation were independent predictors of prognosis.A significantly increased risk of recurrence was particularly evident in patients with T2 stage or poorly differentiated tumors.