Abstract:Objective To determine the curative effects of low-temperature plasma radiofrequency ablation and partial laryngectomy for early glottic carcinoma.Methods Sixty patients with early glottic carcinoma who were admitted to the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Bengbu Medical College from August 2013 to July 2018 were retrospectively analyzed. The patients were divided into two groups according to treatment modality. Thirty cases (plasma group) were treated with plasma radiofrequency ablation (all male, aged 52-74 years old), and 30 cases (partial laryngectomy group) were treated with partial laryngectomy (all male, aged 53-72 years old). Operation time, intraoperative blood loss, postoperative pain visual analogue scale(VAS) score, postoperative hospital stay, mucosal recovery, complications, and laryngeal function recovery were compared and analyzed between the two groups.Results (1) The operation time, intraoperative blood loss, postoperative pain visual analogue scale(VAS) score, postoperative hospital stay duration, and mucosal recovery scores were (12.56±2.34) min, (8.72±1.31) mL, (4.35±1.26) points, (3.53±1.41) days, and (6.25±1.32) points, respectively, in the plasma group. They were (100.00±8.34) min, (80.71±1.05) mL, (5.37±1.12) min, (11.45±1.05) days, and (3.25±1.34) points, respectively, in the partial laryngectomy group, and the differences were statistically significant (t=55.291, 234.873, 3.311, 24.682, 8.741, respectively; all P values<0.01). (2)As for the postoperative complications, the choke cough score was (3.53±0.75) points in the plasma group and (6.01±1.12) points in the partial laryngectomy group, and the difference was statistically significant (t=10.077, P<0.01). The incidences of infection, granulation tissue hyperplasia, and recurrence after operation in the plasma group were 0, 16.67% (5/30), and 3.33% (1/30), respectively, after plasma radiofrequency ablation and 6.67% (2/30), 10.00% (3/30), and 3.33% (1/30), respectively, after partial laryngectomy, and the differences between these incidences were not significant (all P values>0.05). (3)As for the laryngeal function recovery, the fundamental frequency (Jitter), amplitude (Shimmer), and harmonic-to-noise ratio (HNR) in the plasma group were 0.82%±0.15%, 6.37%±1.23%, and 12.86±2.21, respectively, pre-surgery and 0.61%±0.14%, 4.62%±1.21%, and 17.69±2.41, respectively, a year post-surgery. The Jitter, Shimmer, and HNR values in the partial laryngectomy group were 0.91%±0.27%, 6.34%±1.01%, and 13.19±2.66, respectively, before surgery and 0.76%±0.17%, 5.54%±0.96%, and 16.01±1.57, respectively, a year post-surgery. No significant difference was observed in the preoperative Jitter, Shimmer, and HNR values between the two groups(all P values>0.05). The differences between the two groups 1 year after operation were statistically significant (P<0.01). The Jitter and Shimmer values in the two groups were lower and HNR was higher 1 year after surgery than before surgery, and the differences were statistically significant (all P values<0.05).Conclusions Low-temperature plasma radiofrequency ablation under self-retaining laryngoscope in the treatment of early glottic carcinoma has the advantages of short operation time, less operation blood loss, short hospital stay, good recovery of postoperative mucosa and voice, and low incidence of postoperative cough and is therefore worthy of clinical promotion and application.
孙海, 詹晓东, 舒继红, 蒋成义. 低温等离子射频消融与喉部分切除术治疗早期声门型喉癌的疗效比较[J]. 中华解剖与临床杂志, 2021, 26(3): 333-338.
Sun Hai, Zhan Xiaodong, Shu Jihong, Jiang Chengyi. Efficacy analysis of low-temperature plasma radiofrequency ablation and partial laryngectomy for early glottic carcinoma. Chinese Journal of Anatomy and Clinics, 2021, 26(3): 333-338.
Brady JS, Marchiano E, Kam D, et al. Survival impact of initial therapy in patients with T1-T2 glottic squamous cell carcinoma[J]. Otolaryngol Head Neck Surg, 2016, 155(2): 257-264. DOI:10.1177/0194599816638085.
Zeitels SM. Transoral and transcervical surgical innovations in the treatment of glottic cancer[J]. Otolaryngol Clin North Am, 2015, 48(4): 677-685. DOI:10.1016/j.otc.2015.04.012.
[4]
Hoffmann C, Cornu N, Hans S, et al. Early glottic cancer involving the anterior commissure treated by transoral laser cordectomy[J]. Laryngoscope, 2016, 126(8): 1817-1822. DOI:10.1002/lary.25757.
[5]
Shuang Y, Li C, Zhou X, et al. Outcomes of radiofrequency ablation (RFA) and CO2 laser for early glottic cancer[J]. Am J Otolaryngol, 2016, 37(4): 311-316. DOI:10.1016/j.amjoto.2016.03.002.
[6]
Valls-Mateus M, Ortega A, Blanch JL, et al. Long-term quality of life after transoral laser microsurgery for laryngeal carcinoma[J]. J Surg Oncol, 2016, 114(7): 789-795. DOI:10.1002/jso.24471.
Xu X, Deng WT, Huang CZ, et al. Curative effect analysis of endoscopic laryngeal surgery with plasma radiofrequency ablation versus open surgery to treat early glottic cancer[J]. J Otolaryngol Ophthalmol Shandong Univ, 2019, 33(2): 81-85. DOI:10.6040/j.issn.1673-3770.0.2018.177.
[8]
Adelstein D, Gillison ML, Pfister DG, et al. NCCN Guidelines Insights: Head and Neck Cancers, Version 2.2017[J]. J Natl Compr Canc Netw, 2017, 15(6): 761-770. DOI:10.6004/jnccn.2017.0101.
[9]
Piazza C, Paderno A, Grazioli P, et al. Laryngeal exposure and margin status in glottic cancer treated by transoral laser microsurgery[J]. Laryngoscope, 2018, 128(5): 1146-1151. DOI:10.1002/lary.26861.
[10]
Peretti G, Piazza C, Mora F, et al. Reasonable limits for transoral laser microsurgery in laryngeal cancer[J]. Curr Opin Otolaryngol Head Neck Surg, 2016, 24(2): 135-139. DOI:10.1097/MOO.0000000000000240.
[11]
Shuang Y, Li C, Zhou X, et al. Outcomes of radiofrequency ablation (RFA) and CO2 laser for early glottic cancer[J]. Am J Otolaryngol, 2016, 37(4): 311-316. DOI:10.1016/j.amjoto.2016.03.002.
[12]
Scarlata S, Fuso L, Lucantoni G, et al. The technique of endoscopic airway tumor treatment[J]. J Thorac Dis, 2017, 9(8): 2619-2639. DOI:10.21037/jtd.2017.07.68.
Wu Y, Fei CS, Li Y. Analysis on the effect of transoral hypothermic plasma surgery on early glottic carcinoma involving anterior commissure[J]. Chongqing Medicine, 2019, 48(16): 2797-2799, 2803. DOI:10.3969/j.issn.1671-8348.2019.16.024.
Yang SZ, Zhou CY, Wang F, et al. Analysis of curative effect of transoral radiofrequency ablation microsurgery on glottic carcinoma with anterior commissure involvement at the early stage[J].Chin J Otorhinolaryngol Head Neck Surg, 2018, 53(2): 86-91. DOI:10.3760/cma.j.issn.1673-0860.2018.02.002.
Zhao CH, Li YJ, Yu M, et al. Clinical investigation of CO2 laser and low temperature plasma surgery for precancerous laryngeal lesions[J]. China Journal of Endoscopy, 2015, 21(8): 790-793.
Wang XF, Gao XQ. Observation of curative effection of coblation for early glottic carcinoma[J]. Chin Arch Otolaryngol Head Neck Surg, 2016, 23(9): 495-497. DOI:10.16066/j.1672-7002.2016.09.001.
[17]
Wang Z, Zhang Y, Cui H, Yao W. Endoscopic low-temperature plasma radiofrequency ablation for laryngeal plexiform neurobromatosis-1 in an infant: case report and review of the literature[J]. Technol Health Care, 2016, 24(5): 775-80. DOI:10.3233/THC-161218.
Lyu Z, Wen LH, Deng LB. Clinical effect of low-temperature plasma radiofrequency ablation on early laryngeal cancer and precancerous laryngeal lesions[J]. Guangxi Medical Journal, 2017, 39(10): 1480-1482. DOI:10.11675/j.issn.0253-4304.2017.10.06.
Ju LX, Li JC, Luo S. Effective comparison of minimally invasive low temperature plasma radiofrequency ablation versus vertical hemilaryngectomy in the treatment of early glottic cancer[J]. Medical Journal of Wuhan University, 2019, 40(4): 617-620. DOI:10.14188/j.1671-8852.2018.0601.
Lu DS, Feng YJ, Zeng CR, et al. Curative effect analysis of endoscopy low-temperature plasma radiofrequency ablation and normal laryngeal crack treatment in early glottis type of throat cancer[J]. J Clin Pathol Res, 2016, 36(12): 1975-1980. DOI:10.3978/j.issn.2095-6959.2016.12.016.