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タイトル: Post-operative pharyngocutaneous fistula after laryngectomy
著者: Wakisaka, Naohiro link image link image
Murono, Shigeyuki link image
Kondo, Satoru link image link image
Furukawa, Mitsuru link image
Yoshizaki, Tomokazu link image link image
脇坂, 尚宏
室野, 重之
近藤, 悟
古川, 仭
吉崎, 智一
発行日: 2008年 6月
出版社(者): Elsevier
雑誌名: Auris Nasus Larynx
ISSN: 0385-8146
巻: 35
号: 2
開始ページ: 203
終了ページ: 208
キーワード: Chemotherapy
Laryngeal carcinoma
Pharyngocutaneous fistulae
Radiotherapy
Salvage laryngectomy
抄録: Objectives: Although organ-preserving radiotherapy or chemoradiotherapy has offered good locoregional control, many patients still experience recurrent disease requiring salvage laryngectomy. The pharyngocutaneous fistula (PCF) is a common and troublesome complication in the early post-operative period after laryngectomy. Here, we evaluated the cause of PCF after laryngectomy, with special emphasis on radiotherapy and/or chemotherapy. Patients and methods: A total of 63 consecutive patients undergoing salvage total laryngectomy for squamous cell carcinoma of the larynx at Kanazawa University Hospital from 1990 to 2005 were reviewed. Forty of the 63 had received primary total laryngectomy (PL). Ten patients underwent radiotherapy alone (SL-RT) and 13 patients underwent concurrent chemoradiotherapy (SL-CRT) followed by salvage laryngectomy. Results: Overall, 17 of the 63 patients (27.0%) developed PCF after laryngectomy. Fisher's exact test showed a significant increase of PCF formation in SL-CRT (7/13, 53.8%) compared with PL (7/40, 17.5%) (p = 0.0252). There were non-significant increases of PCF formation both in SL-CRT (7/13, 53.8%) compared with SL-RT (3/10, 30.0%) (p = 0.4015), and also in SL-RT (3/10, 30.0%) compared with PL (7/40, 17.5%) (p = 0.3969). The Mann-Whitney U-test showed that the duration of PCF was significantly longer for SL-CRT PCF (121.2 ± 95.0 days) compared with those for PL (39.0 ± 55.3 days) (p = 0.0298) or SL-RT (28.0 ± 16.2 days) (p = 0.0325). However, we did not find a significant difference in the duration of PCF with respect to PL (39.0 ± 55.3 days) and SL-RT (28.0 ± 16.2 days) (p = 0.4367). Conclusions: Although radiotherapy or chemotherapy has only a limited impact on PCF formation, concurrent chemoradiotherapy significantly increases PCF formation. The addition of chemotherapy to irradiation delays PCF closure. © 2007 Elsevier Ireland Ltd. All rights reserved.
DOI: 10.1016/j.anl.2007.06.002
URI: http://hdl.handle.net/2297/9827
資料種別: Journal Article
版表示: author
出現コレクション:1. 査読済論文

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