Larynx cancer treatment results: Survive and quality of life assessment

BİLAÇ, Ömer; USLU, Celil; KARAMAN, Murat; DERNİZ, Mahmut; AKDUMAN, Davut; DURMUŞ, Ruhi; TÜRK, Özlem

Larynx cancer treatment results: Survive and quality of life assessment

Davut AKDUMAN, (Sağlık Bakanlığı, Ümraniye Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Murat KARAMAN, (Sağlık Bakanlığı, Ümraniye Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye)

Celil USLU, (Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Kliniği, İstanbul, Türkiye)

Ömer BİLAÇ, (Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Kliniği, İstanbul, Türkiye)

Özlem TÜRK, (Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Kliniği, İstanbul, Türkiye)

Mahmut DERNİZ, (Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Kliniği, İstanbul, Türkiye)

Ruhi DURMUŞ (Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Kliniği, İstanbul, Türkiye)

Kulak Burun Boğaz İhtisas Dergisi

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Yıl: 2010 Cilt: 20 Sayı: 1 Sayfa Aralığı: 25 - 32 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Larynx cancer treatment results: Survive and quality of life assessment

Öz:

Amaç: Larenks kanserlerinin tedavi yaklaşımına katkıda bulunmak için larenks kanseri cerrahi sonuçlarımız ve hastaların ameliyat sonrası yaşam kaliteleri değerlendirildi. Hastalar ve Yöntemler: Geriye dönük yapılan bu klinik çalışmaya 43 larenks kanserli hasta (38 erkek, 5 kadın; ort. yaş 57.6yıl; dağılım 34-84 yıl) dahil edildi. Hastaların 29’una total larenjektomi/near total larenjektomi (TL/NTL), 13’üne suprakrikoidlarenjektomi (SKL) ve bir hastaya da supraglottik larenjektomiuygulandı. Otuz dokuz hastaya boyun diseksiyonu uygulandı. İkihastaya ameliyat öncesi, 11 hastaya ameliyat sonrası, radyoterapi (RT) uygulandı. Hastalar yaş, cinsiyet, sigara-alkol kullanımı,tümörün yerleşimi-histopatolojisi-evresi, cerrahi ve RT, ameliyatsonrası komplikasyonlar ve sağkalım açısından değerlendirildi.Değerlendirmede yaşam kalitesi QLQ-C30 ve QLQ-H ve N35anketleri kullanıldı, hayatta olan ve anketleri kendi dolduran 26hastanın formu değerlendirildi. Bulgular: Ameliyat sonrası komplikasyon olarak en sık görülenfarengokütanöz fistül (%41.3), sadece TL/NTL hastalarındagelişti. Ameliyat sonrası hastanede kalış süresi ortalama 21.2gün idi. Larenks koruma, peristomal nüks ve lokal nüks oranlarısırasıyla %64.3, %6.9 ve %9.3 olarak saptandı. Genel sağkalımoranı %88.8 ve ortalama sağkalım süresi ise 62.4 ay olarakbulundu. Yaşam kalitesinin değerlendirmesinde, konuşma sorunları (p<0.01) ve öksürme indeksi (p<0.05) TL/NTL grubunda SKLgrubuna göre anlamlı düzeyde yüksek bulundu. İki grup arasındaRT’ye bağlı değişiklik anlamlı bulunmadı (p>0.05). Sonuç: Cerrahi sonuçlarımız önceki çalışmalarla uyumlu bulundu. Larenksin korunması, konuşmayı olumlu etkilemekle birlikte, diğer yaşam kalitesi parametrelerinde değişikliğe nedenolmadı. Ayrıca kalıcı trakeostomi öksürüğü belirgin olarak artırdı. Larenks kanserlerinde en iyi tedavi stratejisini belirlemekiçin; aynı evreli olgulara uygulanan farklı tedavi yöntemlerinin,yaşam kaliteleriyle karşılaştırıldığı çok merkezli çalışmalargerekmektedir.

Anahtar Kelime:

Konular: Cerrahi

Larenks kanseri tedavi sonuçları: Sağkalım ve yaşam kalitesi değerlendirilmesi

Öz:

Objectives: To make a contribution to the treatment modality of larynx cancer, we evaluated our surgical outcomes of the patients withlarynx cancer and their quality of life in the postoperative period. Patients and Methods: Forty-three patients (38 males, 5 females;mean age 57.6 years; range 34 to 84 years) with larynx cancerwere included in this retrospective clinical study. Total laryngectomy/near total laryngectomy (TL/NTL) was performed in 29patients, supracricoid laryngectomy in 13 patients and supraglottic laryngectomy in one patient. Neck dissection performed in 39patients. Two patients had preoperative and eleven patients hadpostoperative radiotherapy (RT). The patients were evaluated withrespect to age, sex, smoking, alcohol consumption, localizationdifferentiation-stage of the tumor, surgery and RT, postoperativecomplications and survival. QLQ-C30 and QLQ-H and N35 questionnaires were used and the results of 26 patients who were aliveand filled in the questionnaires themselves were evaluated. Results: The most frequent postoperative complication waspharyngocutaneous fistula (41.3%), which occurred only inTL/NTL patients. Mean postoperative hospitalization time was21.2 days. Laryngeal preservation, peristomal recurrence andlocoregional recurrence rates were 64.3%, 6.9% and 9.3%respectively. Overall survival rate was 88.8%. Mean survival timewas 62.4 months. In quality of life assessment, speech problem(p<0.01) and cough index (p<0.05) were significantly higher inTL/NTL group than SCL group (p<0.05). There were no significant difference in both groups with respect to RT (p>0.05). Conclusion: Our surgical outcomes are compatible with theprevious studies. Although the larynx preservation had a positiveeffect on the speech, it did not affect other quality of life parameters. In addition, having a permanent tracheostomy increasedcough index markedly. We emphasize that multi-institutionalprospective quality of life studies comparing different treatmentmethods for similar stage tumors are essential in defining theoptimal management strategy in patients with larynx cancer.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	AKDUMAN D, KARAMAN M, USLU C, BİLAÇ Ö, TÜRK Ö, DERNİZ M, DURMUŞ R (2010). Larynx cancer treatment results: Survive and quality of life assessment. , 25 - 32.
Chicago	AKDUMAN Davut,KARAMAN Murat,USLU Celil,BİLAÇ Ömer,TÜRK Özlem,DERNİZ Mahmut,DURMUŞ Ruhi Larynx cancer treatment results: Survive and quality of life assessment. (2010): 25 - 32.
MLA	AKDUMAN Davut,KARAMAN Murat,USLU Celil,BİLAÇ Ömer,TÜRK Özlem,DERNİZ Mahmut,DURMUŞ Ruhi Larynx cancer treatment results: Survive and quality of life assessment. , 2010, ss.25 - 32.
AMA	AKDUMAN D,KARAMAN M,USLU C,BİLAÇ Ö,TÜRK Ö,DERNİZ M,DURMUŞ R Larynx cancer treatment results: Survive and quality of life assessment. . 2010; 25 - 32.
Vancouver	AKDUMAN D,KARAMAN M,USLU C,BİLAÇ Ö,TÜRK Ö,DERNİZ M,DURMUŞ R Larynx cancer treatment results: Survive and quality of life assessment. . 2010; 25 - 32.
IEEE	AKDUMAN D,KARAMAN M,USLU C,BİLAÇ Ö,TÜRK Ö,DERNİZ M,DURMUŞ R "Larynx cancer treatment results: Survive and quality of life assessment." , ss.25 - 32, 2010.
ISNAD	AKDUMAN, Davut vd. "Larynx cancer treatment results: Survive and quality of life assessment". (2010), 25-32.

APA	AKDUMAN D, KARAMAN M, USLU C, BİLAÇ Ö, TÜRK Ö, DERNİZ M, DURMUŞ R (2010). Larynx cancer treatment results: Survive and quality of life assessment. Kulak Burun Boğaz İhtisas Dergisi, 20(1), 25 - 32.
Chicago	AKDUMAN Davut,KARAMAN Murat,USLU Celil,BİLAÇ Ömer,TÜRK Özlem,DERNİZ Mahmut,DURMUŞ Ruhi Larynx cancer treatment results: Survive and quality of life assessment. Kulak Burun Boğaz İhtisas Dergisi 20, no.1 (2010): 25 - 32.
MLA	AKDUMAN Davut,KARAMAN Murat,USLU Celil,BİLAÇ Ömer,TÜRK Özlem,DERNİZ Mahmut,DURMUŞ Ruhi Larynx cancer treatment results: Survive and quality of life assessment. Kulak Burun Boğaz İhtisas Dergisi, vol.20, no.1, 2010, ss.25 - 32.
AMA	AKDUMAN D,KARAMAN M,USLU C,BİLAÇ Ö,TÜRK Ö,DERNİZ M,DURMUŞ R Larynx cancer treatment results: Survive and quality of life assessment. Kulak Burun Boğaz İhtisas Dergisi. 2010; 20(1): 25 - 32.
Vancouver	AKDUMAN D,KARAMAN M,USLU C,BİLAÇ Ö,TÜRK Ö,DERNİZ M,DURMUŞ R Larynx cancer treatment results: Survive and quality of life assessment. Kulak Burun Boğaz İhtisas Dergisi. 2010; 20(1): 25 - 32.
IEEE	AKDUMAN D,KARAMAN M,USLU C,BİLAÇ Ö,TÜRK Ö,DERNİZ M,DURMUŞ R "Larynx cancer treatment results: Survive and quality of life assessment." Kulak Burun Boğaz İhtisas Dergisi, 20, ss.25 - 32, 2010.
ISNAD	AKDUMAN, Davut vd. "Larynx cancer treatment results: Survive and quality of life assessment". Kulak Burun Boğaz İhtisas Dergisi 20/1 (2010), 25-32.