Abstract | Cilj istraživanja: Cilj ovog istraživanja bio je prikazati incidenciju plućnih metastaza
pločastog karcinoma grkljana u trenutku postavljanja dijagnoze kroz petogodišnje razdoblje.
Materijali i metode: Provedeno je retrospektivno istraživanje u kojem su uključeni svi
bolesnici s dijagnosticiranim pločastim karcinom grkljana u Klinici za bolesti uha, nosa i grla
s kirurgijom glave i vrata KBC-a Split u razdoblju od 1. siječnja 2017. do 31. prosinca 2021. U
istraživanju je ispitana priroda i ponašanje pločastog karcinoma grkljana s obzirom na
čimbenike kao što su dob, spol, anatomska podjela tumora, prvi simptom, histološki i klinički
stupanj, učestalost metastaziranja, čimbenici rizika i primjena kirurgije u liječenju.
Rezultati: U istraživanje su uključena 153 ispitanika od kojih je 5,2% imalo potvrđene
metastaze na plućima. Srednja dob za pojavu pločastog karcinoma grkljana je bila 65,47 ± 8,9,
medijan je 65. Omjer muškaraca naspram žena s plućnim metastazama je 7:1. Dob iznad 65 je
imalo 87,5% ispitanika s plućnim metastazama. Glotičko i supraglotičko područje zajedno čine
25% karcinoma s plućnim metastazama, a subglotiči karcinomi nisu dali nijednu metastazu.
Histološki gradus G II je najčešći stupanj diferencijacije karcinoma grkljana. Klinički stadij I
ima 39,9% karcinoma grkljana, stadij II 9,2%, stadij III 22,2%, a stadij IV 28,8%. Svega 9,8%
bolesnika s karcinomom grkljana su nepušači. Uspoređujući pre-COVID i COVID razdoblje,
postoji značajna statistička razlika među stadijima karcinoma (P<0,001). U COVID–19
pandemiji bolesnici su se javljali s uznapredovalim karcinom, što je sukladno činjenici da je
bio ograničen pristup bolnicama. U petogodišnjem razdoblju, pojava plućnih metastaza
zabilježena je 2020. i 2021. godine sa statistički značajnom razlikom između razdoblja prije i
poslije pandemije (P<0,01).
Zaključak: Vodeće sijelo metastaza pločastog karcinoma grkljana su pluća. Njihova
incidencija i dalje nije visoka. Pandemija je imala bitan utjecaj na porast broja uznapredovalih
karcinoma grkljana i plućnih metastaza. Rano otkrivanje je bitno za prognozu karcinoma
grkljana. |
Abstract (english) | Objectives: The aim of this study was to show the incidence of lung metastases of laryngeal
squamous cell carcinoma at the time of diagnosis over a five-year period.
Subjects and methods: This retrospective study included all patients diagnosed with squamous
cell carcinoma of the larynx at the Department of Ear, Nose and Throat with Head and Neck
Surgery at University Hospital of Split within the period from January 1st 2017 to December
31st 2021. The study investigated the nature and behavior of laryngeal squamous cell carcinoma
regarding to factors such as age, gender, anatomical division of the tumor, first symptom,
histological and clinical grade, frequency of metastases, risk factors and use of surgery in
treatment.
Results: Lung metastases were confirmed in 5.2% of the 153 patients included in the study.
The mean age for the occurence of laryngeal squamous cell carcinoma was 65.47 ± 8.9, and the
median was 65. The ratio of men to women with lung metastases was 7:1. 87.5% of the
respondents with lung metastases were over 65. Glottic and supraglottic areas together
accounted for 25% of the cancers with lung metastases, whereas subglottic cancers showed no
metastases. Histological grade G II was the most common stage of differentiation of laryngeal
cancer. Clinical stage I cancers accounted for 39.9% of the laryngeal cancers, whereas 9.2%
were at stage II, 22.2% were at stage III, and 28.8% were at stage IV. As much as 9.8% of
patients with laryngeal cancer were non-smokers. Comparing the pre-COVID and the COVID
period, a significant statistical difference was found between cancer stages (P<0.001). During
the COVID-19 pandemic, there were more patients with advanced cancer, which is consistent
with the fact that access to hospitals was limited. In the studied five-year period, the occurrence
of lung metastases was recorded in 2020 and 2021 with a statistically significant difference
between the period before and after the pandemic (P<0.01).
Conclusion: The most common site for metastases of squamous cell carcinoma of the larynx
were the lungs. However, their incidence was not particularly high. The pandemic has had a
significant impact on the increase in the number of advanced laryngeal cancers and lung
metastases. Early detection is essential for the prognosis of laryngeal cancer. |