当科における進行喉頭癌（stage III, IV）症例の検討

Review of the Treatment for Advanced Laryngeal Cancer (stage III, IV)

　はじめに

　喉頭癌は頭頸部悪性腫瘍の中で最も頻度の高い腫瘍であるが，その予後は比較的良好である。一般に早期喉頭癌には放射線治療が多く行われ，その根治性も高い。それに対して進行喉頭癌には手術を主体にした治療が行われ，その治療成績も向上しているが，まだ満足できるものではない。今回われわれは，琉球大学医学部附属病院耳鼻咽喉科で，一次治療を行った進行喉頭癌（stage III, IV）症例について検討し，治療成績改善のための若干の考察を行ったので報告する。

From 1984 through 1995, 45 patients with laryn-geal carcinoma, in which 24 were classified into stage III and 21 stage IV, were treated.

Prognosis of these cases were as follows ; 27 patients (60%) survived, 12 patients (27%) died ofprimary disease, and 6 patients (13%) died of the other diseases.

The overall 5-year survival rate was 60%. The 5-year survival rate for the glottic cancer and 3-year survival rate for the supraglottic cancer were 68% and 43% respectively.

To improve the survival rate for advanced laryn-geal cancer, paratracheal dissection for glottic can-cer, and bilateral neck dissection for supraglottic cancer were recommended.

Preoperative tracheostomy was not recommended for reason of stomal recurrence. Chemotherapy could be administered to prevent the distant metas-tasis.