Indifferentiated carcinoma of the nasopharyngs is clinicaly-histological-imunologic entity which is often diagnosed in our country .There are three clinical types, but nodal cervical type of disease is the most interesting type for surgeons while the combined type is more interesting for otolaryngologist. Among seventy-seven patients diagnosed with undifferentiated carcinoma of the nasopharyngs with nodal cervical type of disease, on the Institute of Otolaryngology and Maxillofacial Surgery Clinical Center of Serbia during the period between 1993.-1997. there were N0-21%, N1-49%, N2-18% i N3-12%, no mater of the T category .The disease more often occurs between male population (2:1), mostly between age 41 -60. The rate for five year period of surviving for two different chemioterapeutical protocols is as follows: for categories NO and N1-20% for mono Zorubicin and 61% for the same category for Z-CDDP. The same rate for categories N2 and N3 is 11% for mono Zorabicin and 33% for the same category for Z-CDDP. Much better rate of survival in comparison with previous decades is achieved due to better diagnosing on time in which are systematically included epypharyngoscopy in general anesthesia with biopsy, CT and NMR and EBV serology.
Indifferentiated carcinoma of the nasopharyngs is clinicaly-histological-imunologic entity which is often diagnosed in our country. There are three clinical types, but nodal cervical type of disease is the most interesting type for surgeons while the combined type is more interesting for otolaiyngologist. Among seventy-seven patients diagnosed with undifferentiated carcinoma of the nasopharyngs with nodal cervical type of disease, on the Institute of Otolaryngology and Maxillofacial Surgery Clinical Centre of Serbia during the period between 1993-1997 there were N0-21%, N1-49%, N2-18% i N3-12%, no mater of the T category. The disease more often occurs between male population (2:1), mostly between age 41-60. The rate for five year period of surviving for two different chemioterapeutical protocols is as follows: for categories N0 and N1-20% for mono Zorubicin and 61% for the same category for Z-CDDP. The same rate for categories N2 and N3 is 11% for mono Zorubicin and 33% for the same category for Z-CDDP. Much better rate of survival in comparison with previous decades is achieved due to better diagnosing on time in which are sistematicaly ineluded epypharyngoscopy in general anestesia with biopsy, CT and NMR and EBV serology.
Modern therapeutical protocols for treatment of T3 and T4 malignomas of the larynx are not adjusted, because there are attempts to treat these diseases with non-operative methods (such as chemo- and radiotherapy) in order to preserve the organ. The aim of the study was to establish today's results of the surgical treatement of patients with T3 and T4 laryngeal malignoma. We studied the group of patients with laryngeal carcinoma, who had undergone total laryngectomy, during the period of eight years (1990-1997). The patients' data was submitted from medical documentation, it was filled in specially designed questionnaries and was statistically reviewed. During this eight-year-period, 1054 total laryngectomies were done. The five-years survival rate, established in the group of patients who had undergone total laryngectomiy is 308/794 (39%). In the patient group where total laryngectomy was salvage surgery after radiotherapy, the five-years survival rate is 47/172 (27%). In the patient group where total laryngectomy was salvage surgery after conservative or reconstructive surgery, the five-years survival rate is 28/84 (33%). Despite diagnostical and therapeutical achievements, prognosis for T3 and T4 malygnoma of the larynx was not significantly approved in the last few decades.
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