Kravchenko D. The improvement diagnostic and surgical treatment of the patients with glottic laryngeal cancer

Thesis is dedicated to improving results of diagnostics and surgical treatment of glottic laryngeal cancer (GLC) stage I-III with integrated Multidetector Computed Tomography (іMDCT) and the development of organ-saving resection of the larynx (a segmental resection of the thyroid cartilage with the removal of laryngeal tumor). The study is based on the results of examination and treatment of 212 patients with GLC stage I-III. It was found that the use of an iMDCT (native CT, angiography and functional vocal tests during MDCT) has advantages over other radiation methods of research: linear tomography of the larynx, ultrasound (US) of larynx, neck MDCT. When neck iMDCT is done, sensitivity and accuracy reached 95.5 % and 92.8 %. The three-year recurrence-free survival in the study group was 0,84 (the survey was supplemented with an neck iMDCT) whereas in the comparison group it was 0,64 (the study was conducted according to the requirements of the "Protocols of medical care"). There was a significant difference between these two groups of patients (? = 2,46; р < 0,05; ?2 = 6,67; p < 0,05). The optimum method of clarification of localization and T-staging of GLC before the operation and determination of resection zone of GLC, allowing for a segmental resection of the thyroid cartilage with the removal of laryngeal tumor. The one-year recurrence-free survival (after the application of the developed method of segmental resection of the larynx) was significantly better compared with glottektomy (? = 2,39; р < 0,05) and the method of subtotal resection of the larynx (? = 2,75; р < 0,05).