抄録
A clinical study was made of 102 patients with previously untreated laryngeal cancer registered in our department for 15 years between 1984 and 1998.
Their mean age was 65.0 years, ranging between 39 and 83. The male to female ratio was 16:1. The proportion of non-smokers was 4.9%. The study consisted of 77 patients with glottic carcinoma (75%), 19 with supraglottic carcinoma (19%) and 6 with subglottic carcinoma (6%). The sexual difference with regard to the proportion of glottic carcinoma was 78% in males and 33% in females. Therefore, the male to female ratios according to the primary sites were 38:1 for the glottis and 5:1 for the supraglottis.
According to the TNM classification (UICC 1987), there was a marked differences in the distribution between the glottic type and the supraglottic type. For the glottic type, 46 patients (60%) were stage I, 19 (25%) were stage II, 10 (13%) were stage II and 2 (3%) were stage IV, whereas for the supraglottic type, 3 (16%) were stage I, 5 (26%) were stage II, 5 (26%) were stage III and 6 (32%) were stage IV. The overall 5-year cause-specific survival rate was 85%. The survival rates for the glottic type were significantly higher than those for the supraglottic type. The 5-year cause-specific survival rate for the glottic type was 94%, whereas the supraglottic type was 68%. The 5-year larynx preservation rate for the glottic T1 and T2 cancers were 96% and 79%, respectively. Those for the supraglottic T1 and T2 cancers were both 0%. To improve the 5-year larynx preservation rate, irradiation of the disease during primary treatment while preserving the larynx is essential. Factors to improve survival rates of carcinoma of the larynx are discussed.
