진행된 하인두암의 동시 항암화학 방사선 요법 후 구제 수술의 결과

류인선; 한명월; 노종렬; 남순열; 김상윤; 최승호

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자료유형: 학술저널

저자정보: 류인선 한명월 노종렬 남순열 김상윤 최승호

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제54권 제10호

발행연도: 2011.1

수록면: 703 - 710 (8page)

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Background and Objectives We evaluated treatment outcomes of patients with advanced hypopharyngeal cancer for whom surgical salvage was attempted after primary concomitant chemoradiation therapy (CRT) had failed as a treatment. The pre-salvage factors were assess-ed to predict the prognosis of salvage surgery. Subjects and Method A retrospective analysis was conducted from 1997 to 2006 for 22 patients with stage III-IV hypopharyngeal cancer who had undergone salvage surgery after local and/or regional CRT failures with no distant metastasis. Results Larynx-sacrificing pharyngectomy was performed in 12 (54.5%) of all patients. Postoperative complications occurred in 9 (40.9%), and carotid artery blowout occurred in two of these patients. After salvage surgery, the 2-year and 5-year overall survival rates were 52.8% and 28.9%, respectively. The 2-year disease specific survival rate and locoregional control rate were 45.5% and 60.0%, respectively. The initial N2-3 stage (p=0.038) and the concurrent local and regional failures (p=0.035) were independent predictors for decreased survival after salvage surgery. Two-year overall survival rates for patients with 2, 1, or none of these predictive factors were 23.3%, 66.7%, and 80.0%, respectively (p=0.027). Conclusion Although salvage surgery after CRT has postoperative complications and unfavorable larynx preservation, it can be considered as a viable option with acceptable oncologic outcomes for advanced hypopharyngeal cancer. The initial N2-3 stage and concurrent local and regional failures were independent predictors that can stratify patients into distinct prognostic groups for postsalvage survival.

#Hypopharyngeal cancer ㆍTreatment failure ㆍSurgery ㆍLocoregional failure ㆍSalvage therapy.

참고문헌 (23)

참고문헌 신청

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Armand JP / 1993 / Salvage chemotherapy in recurrent head and neck cancer:the Institut Gustave Roussy experience / Am J Otolaryngol 14 (5) : 301 ~ 306

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Clark JR / 2006 / Primary and salvage(hypo)pharyngectomy:analysis and outcome / Head Neck 28 (8) : 671 ~ 677