Author/Editor		Balatoni, Zsuzsa; Elo, Janos; Kotai, Zsuzsa
Title		Surgical treatment of advanced oropharyngeal cancer with preservation of the larynx
Translated title		Kirurško zdravljenje raka na orofarinksu z ohranjenim larinksom
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 33, št. 2
Publication year		1999
Volume		str. 159-62
Language		eng
Abstract		Background and methods. This retrospective study evaluates the oncological and functional results obtained in 61 patients with advanced oropharyngeal cancer who underwent extended tumor resection as a primary procedure or as a salvage surgery form. Results. Although the oropharyngeal cancers involved the base of the tongue, or some of them extended to the lateral hypopharyngeal wall, the surgery was performed without total laryngectomy. The tumor extended to the vallecula and/or to the pharyngoepiglottic fold in five cases, which required supraglottic laryngectomy. The closure following the extended resection of the tumor was made with flap reconstruction in all patients. The preferred method was employing the pectoralis major myocutaneus flap. The survival rates were 75%, at 1 year and 31 %, at 2 years and 25% from 2 to 5 years with recurrence of the disease. In one patient, the nasogastric tube could not have been removed, and another patient could be decannulated only after postoperative radiation because of the persistent oedema. Conclusions. A satisfactory functional result was obtained in this series. In most of our patients, good functioning of larynx as well as voice preservation were secured.
Summary		Izhodišča in metode. V retrospektivni raziskavi smo poskušali z onkološkega in funkcionlanega vidika oceniti rezultate zdravljenja 61 bolnikov z napredovalim rakom na orofarinksu, ki so že prestali razširjeno resekcijo tumorja kot primarno zdravljenje ali pa kot reševalno terapijo. Rezultati. Čeprav je večina rakov na orofarinksu zajemala tudi koren jezika ali se je razširila do stranske stene hipofarinksa, nismo naredili totalne laringektomije. V 5 primerih se je tumor vrasel v območje epiglotisne valekule ali faringoepiglotisa, zato je bila potrebna supraglotisna laringektomija. Po obsežni resekciji tumorja smo pri vseh bolnikih opravili rekonstrukcijo z režnjem, pri kateri smo najbolj pogosto uporabili reženj velike pektoralne mišice. Preživetje je bilo po 1 letu 75%, v času od 2 do 5 let pa je znašalo 31%, vendar s precej pogosto zgodnjo ponovitvijo bolezni. Pri enem bolniku nismo mogli odstraniti nazogastrične sonde, drugemu pa smo zaradi obsežnega in trdovratnega edema lahko odstranili kanilo šele po pooperativnem obsevanju. Zaključki. V tej seriji bolnikov smo glede funkcionalnosti dosegli zadovoljive rezultate. V večini primerov smo pri bolnikih ohranili funkcionalnost farinksa in sposobnost govora.
Descriptors		OROPHARYNGEAL NEOPLASMS LARYNGECTOMY RETROSPECTIVE STUDIES NEOPLASM STAGING LARYNX RADICAL NECK DISSECTION SURGICAL FLAPS TREATMENT OUTCOME