[Pharyngoesophageal stenosis following surgery and radiotherapy in patients with advanced laryngeal cancer].
| Autor: | Rosales Solís AA; Servicio de Endoscopia, Instituto Nacional de Cancerología, México, D.F., Hernández-Guerrero A, Sobrino Cossío S, Frías Medívil M, Córdova Pluma VH, Granados García M, Herrera Gómez A |
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| Jazyk: | Spanish; Castilian |
| Zdroj: | Revista de gastroenterologia de Mexico [Rev Gastroenterol Mex] 2004 Jan-Mar; Vol. 69 (1), pp. 8-15. |
| Abstrakt: | Objective: Our objectives were to 1) know the frequency of pharyngoesophageal stenosis in patients with clinical stage III transglottic laryngeal cancer (LCa Stage III) post-surgery and radiotherapy, and to 2) describe clinical, radiologic, and endoscopic characteristics of pharyngeal-esophageal stenoses and response to dilations. Materials and Methods: We conducted a series of consecutive cases from 1997-2000 at the National Cancer Institute (INCan) in Mexico City and included patients with transglottic (LCa Stage III) post-surgery and -radiotherapy. We evaluated dysphagia and stenosis (length, diameter, and localization) by radiology and endoscopy before and after surgery and radiotherapy. Statistical method was descriptive. Results: Sixty five of 197 cases (33%) with laryngeal cancer were transglottic and 52 (26.3%) were clinical stage III. Patients were treated with total laryngectomy and pharyngo-esophageal "Y" stent and post-operative radiotherapy with average 7,000 cGy total dose. Thirteen patients (25%) presented pharyngo-esophageal stenosis. There was no pre-operative dysphagia; dysphagia was present in five patients post-surgery and in all after radiotherapy. In all cases, stenoses were simple and were treated with Savary Guillard-guided endoscopic dilation with an average of five sessions. Five of 13 patients (38.5%) had persistent dysphagia: two due to fibrosis, two due to loco-regional recurrences, and one due to recurrence in pharyngo-esophageal closure. Conclusions: A total of 197 cases of laryngeal cancer were present during this period; 33% were transglottic, the majority in clinical stage III. Global frequency of stenosis was 25%; all cases were simple. Endoscopic dilations were useful in absence of fibrosis, extrinsic compression, and tumor recurrence. |
| Databáze: | MEDLINE |
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