喉頭癌に対する経口的切除術の適応と限界

抄録

Transoral surgery for laryngeal cancer is becoming a major treatment option due to the increasing need for laryngeal preservation. In our department, transoral laser microsurgery（TLM）is mainly performed for glottis cancer, and transoral videolaryngoscopic surgery（TOVS）, which we established, is performed for supraglottic cancer.The indications for TLM for glottis cancer are Tis, T1, T2, and select T3 cases with vocal fold movement, without invasion into the thyroid cartilage and/or cricoid cartilage. Salvage surgery is indicated for select resectable cases less than rT2 cases. Two-staged surgery is recommended for T1b cases. The indications for TOVS for supraglottic cancer are resectable T1, T2, and select T3 cases with vocal fold movement, without invasion into the thyroid cartilage, cricoid cartilage and/or hyoid bone. Salvage surgery is indicated for select resectable cases less than rT2 cases.The oncological outcome is similar to that of（C）RT or open partial laryngectomy. Vocal function after TLM is also similar to that after（chemo）radiotherapy. The swallowing function after TOVS is favorable.It is important to understand the differences in the indication for open partial laryngectomy and to have the proper knowledge to recommend appropriate treatment options for patients.