• No results found

Disease outcome in T1 glottic carcinoma Sjögren, E.V.

N/A
N/A
Protected

Academic year: 2021

Share "Disease outcome in T1 glottic carcinoma Sjögren, E.V."

Copied!
9
0
0

Bezig met laden.... (Bekijk nu de volledige tekst)

Hele tekst

(1)Disease outcome in T1 glottic carcinoma Sjögren, E.V.. Citation Sjögren, E. V. (2009, December 10). Disease outcome in T1 glottic carcinoma. Retrieved from https://hdl.handle.net/1887/14552 Version:. Corrected Publisher’s Version. License:. Licence agreement concerning inclusion of doctoral thesis in the Institutional Repository of the University of Leiden. Downloaded from:. https://hdl.handle.net/1887/14552. Note: To cite this publication please use the final published version (if applicable)..

(2) %VUDITVNNBSZ/FEFSMBOETFTBNFOWBUUJOH "VUIPSTBOEBG¾MJBUJPOT -JTUPGQVCMJDBUJPOT.

(3) .

(4) %VUDITVNNBSZ/FEFSMBOETFTBNFOWBUUJOH. 4BNFOWBUUJOH )FUEPFMWBOEJUQSPFGTDISJGUJTPN[PXFMEFPODPMPHJTDIFBMTGVODUJPOFMF TUFN CFIBO EFMJOHTSFTVMUBUFOWPPS5HMPUUJTDIMBSZOYDBSDJOPPNUFCFTDISJKWFO°FOPNEF[FUFWFS HFMJKLFOWPPSEFUXFFNFFTUWPPSLPNFOEFCFIBOEFMJOHTNPEBMJUFJUFOSBEJPUIFSBQJFFO MBTFSDIJSVSHJF )PPGETUVLJTFFOBMHFNFOFJOMFJEJOHXBBSJOCBTBMFBOBUPNJFFOGZTJPMPHJFWBOEFMBSZOY BMTNFEF EF QBUIPTGZTJPMPHJF XPSEU CFTQSPLFO %F EF¾OJUJF WBO ²5³ FO ²LMFJO MBSZOY DBSDJOPPN³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qOU UVNPSPGCFIBOEFMJOHTGBDUPSFOVJUEFMJUFSBUVVSXBSFOWBO JOWMPFEPQEF[FVJULPNTU%BBSIFUIJFSFFOQPQVMBUJFHFCBTFFSEFTUVEJFWBOWPMEPFOEF PNWBOHCFUSFGU[JKOXJKWBONFOJOHEBUPO[FSFTVMUBUFOCFUSPVXCBBS[JKO NFUOBNFUFO BBO[JFO WBO HPFE HFEF¾OJFFSEF GBDUPSFO [PBMT TVCTUBEJVN 5BC  FO CFUSPLLFOIFJE WBO EF WPPSTUF DPNNJTTVVS KBOFF  8F DPODMVEFSFO EBO PPL EBU EF[F GBDUPSFO HFFO QSPHOPTUJTDIFXBBSEFIFCCFOCJKEFCFIBOEFMJOHWBO5HMPUUJTDIMBSZOYDBSDJOPPNNFU SBEJPUIFSBQJF7PPSGBDUPSFONFUNFFSXJTTFMFOEFEF¾OJUJFTFOJOEFMJOHFO[PBMTUVNPS HSPPUUF JOEF[FTUVEJFHFEF¾OJFFSEBMTIFUBBOUBMBBOHFEBOFWBOEFTUFNCBOE JTEF WBMJEJUFJUWBOPO[FVJULPNTUFONJOEFSCFUSPVXCBBS PNEBUEFXBBSEFOWBOEFHFLP[FO BGLBQQVOUFONJTTDIJFOOJFUPQUJNBBMXBSFO%BBSCJK[JKOEFSFTVMUBUFOWPPSEF[FGBDUP SFOBMMFFOWFSHFMJKLCBBSNFUTUVEJFTEJFEF[FMGEFEF¾OJUJFIBOUFSFO%FSIBMWFNPFUNFFS [PSH JO BDIU XPSEFO HFOPNFO CJK IFU JOUFSQSFUFSFO WBO EF[F SFTVMUBUFO %BBSCJK HFMEU. .

(5) PO[FCFWJOEJOHEBUHFFOWBOEFCFIBOEFMJOHTQBSBNFUFST[PBMTUPUBMFEPTJT GSBDUJFEPTJT FOCFIBOEFMJOHTEVVSWBOQSPHOPTUJTDIFXBBSEF[JKO BMMFFOWPPSEFCFQFSLUFTQSFJEJOH BBOXBBSEFOEJFJOEF[FTUVEJFWPPSLPNU%FFOJHFGBDUPSNFUFFOTJHOJ¾DBOUFJOWMPFE PQMPDBMFDPOUSPMFXBTFFOOJFVXF OJFUFFSEFSCFTDISFWFOGBDUPSQSFqYJTUFOUFIZQFSUSP ¾TDIFMBSZOHJUJT1BUJqOUFONFUQSFqYJTUFOUFIZQFSUSP¾TDIFMBSZOHJUJTIBEEFOFFOKBBST MPDBMFDPOUSPMFWBOJOUFHFOTUFMMJOHUPUCJKQBUJqOUFO[POEFSQSFqYJTUFOUFIZQFS USP¾TDIFMBSZOHJUJT*ONVMUJWBSJBBUBOBMZTFXBTEF[FGBDUPSHFBTTPDJFFSENFUFFOSFMBUJFG SJTJDPWBO  $*   Q  PQMPLBBMSFDJEJFG8JKWFSNPFEFOEBUQSFqYJT UFOUFIZQFSUSP¾TDIFMBSZOHJUJTHFSFMBUFFSELBO[JKOBBODISPOJTDIFJO¿BNNBUJF7FSEFS POEFS[PFLJTOPEJHPNEF[FUIFPSJFUFPOEFSCPVXFO. . )PPGETUVLJTFFOQPQVMBUJFHFCBTFFSEF SFUSPTQFDUJFWFDPIPSUTUVEJFOBBSIFUSJTJDPWBO TZODISPOFFONFUBDISPOFNBMJHOFUVNPSFOCJKQBUJqOUFONFU5JT5HMPUUJTDIMBSZOYDBS DJOPPN %F[F TUVEJF MBBU [JFO EBU ²PCTFSWFEUPFYQFDUFE SBUJPT³ CJK NBOOFO WFSIPPHE [JKOWPPSNBMJHOJUFJUFOWBOEFQBODSFBT   MPOH   CMBBT   FOIFUDPMPSFDUVN   *OUFHFOTUFMMJOHUPUEFBMHFNFOFWFSXBDIUJOHXBSFOPCTFSWFEUPFYQFDUFESBUJPµT WPPS NBMJHOF UVNPSFO WBO EF NPOEIPMUF  PSP BOE IZQPQIBSZOY    XFMJTXBBS WFS IPPHENBBSOJFUTUBUJTUJTDITJHOJ¾DBOUFOEFSBUJPWPPSNBMJHOJUFJUFOWBOEFTMPLEBSN XBTOJFUWFSIPPHE   *OUFHFOTUFMMJOHUPUEFWFSXBDIUJOHFOJTCJKQBUJqOUFONFUFFO 5JT5HMPUUJTDIMBSZOYDBSJOPPN NFUVJU[POEFSJOHWPPSMPOHNBMJHOJUFJUFO EFSIBMWFIFU SJTJDP WPPS NVMUJQFMF QSJNBJSF UVNPSFO CVJUFO IFU ,/0HFCJFE HSPUFS EBO EJF WBO EF NPOEIPMUF PSPFOIZQPQIBSZOYPGEFTMPLEBSNFOIFCCFOEF[FOJFU,/0UVNPSFOFFO HSPUFSFLBOTPNEFPWFSMFWJOHWBOEFQBUJqOUUFCFuOWMPFEFOEBOFFOUXFFEFIPPGEIBMT UVNPS)JFSVJUDPODMVEFSFOXJKEBUEFMBHFJODJEFOUJFWBOUVNPSFOWBOIFUIPPGEIBMT HFCJFEFOEFTMPLEBSNIFUSPVUJOFNBUJHWFSSJDIUFOWBOEFQBOFOEPTDPQJFCJKEF[FQBUJ FOUFOJOUXJKGFMUSFLU%BBSCJKNPFUEFCFIBOEFMFOE,/0BSUTPQEFIPPHUF[JKOWBOEF WFSIPPHEFJODJEFOUJFBBOSPPLHFSFMBUFFSEFUVNPSFOCVJUFOIFU,/0HFCJFEPNWSPFHEJ BHOPTUJFLFOCFIBOEFMJOHUFLVOOFOCFXFSLTUFMMJHFO )PPGETUVLJTFFOQPQVMBUJFHFCBTFFSEF SFUSPTQFDUJFWFDPIPSUTUVEJFCJKQBUJqOUFONFU5JT 5HMPUUJTDIMBSZOYDBSDJOPPNEJF[JDISJDIUPQEFQSFWBMFOUJFFOJNQBDUWBOFFSEFSFNBMJH OJUFJUFOPQEFUPUBMFPWFSMFWJOH0O[FTUVEJFMBBU[JFOEBUWBOEFQBUJqOUFONFUFFO 5JT5HMPUUJTDIMBSZOYDBSJDOPPNFFOFFSEFSFNBMJHOJUFJUIFFGUHFIBEFOEBUEF[FGBDUPSFFO POBGIBOLFMJKLFJNQBDUIFFGUPQUFUPUBMFPWFSMFWJOH*OEF[FTUVEJFXBTIFUSFMBUJFGSJTJDP PQPWFSMJKEFOCJKQBUJqOUFONFUFFOFFSEFSFNBMJHOJUFJU %JUSJTJDPXBTUJKETBGIBOLFMJKL FOOBNBGOBBS WPPSNBMJHOJUFJUFOEJFNFFSEBONBBOEFOWPPSIFUHMPUUJTDIMBSZOY DBSDJOPPNXBSFOHFEJBHOPTUJDFFSE)FUFGGFDUWBOFFSEFSFUVNPSFOXBTTUFSLFSEBOIFU FGGFDUWBOBOEFSF OJFUNBMJHOFDPNPSCJEJUFJU%F[FTUVEJFMBBU[JFOEBU°POEBOLTEBUEF UPUBMFPWFSMFWJOHIFFMIPPHJTJOEF[FQBUJqOUFOHSPFQ°EJUNJOEFSHFMEUWPPSQBUJqOUFO NFUFFSEFSFUVNPSFO%F[FTUVEJFPOEFSTUFVOUIFUDPODFQUPNEBUBPWFSFFSEFSFUVNP SFO FOEBUBPWFSBOEFSFDPNPSCJEJUFJUFO UFJODMVEFSFOJOFFOUVNPSTUBEJqSJOHTTZTUFFN.

(6) %VUDITVNNBSZ/FEFSMBOETFTBNFOWBUUJOH. [PBMTEF5/.DMBTTJ¾DBUJFPNEFQSPHOPTUJFLUFWFS¾KOFOFOPNEFCFIBOEFMJOHTLFV[FT UFPOEFSTUFVOFOCJKEFJOEJWJEVFMFQBUJqOU )PPGETUVLJTFFOSFUSPTQFDUJFWFDPIPSUTUVEJFOBBSEFCFIBOEFMJOHTVJULPNTUCJK5HMPU UJTDIMBSZOYDBSJOPOPPNJOPOTJOTUJUVVUTJOETEFJOUSPEVDUJFWBOEFFOEPTDPQJTDIF$0 MBTFSDIJSVSHJF BMT BEEJUJPOFMF CFIBOEFMJOHTNPEBMJUFJU WPPS EF[F BBOEPFOJOH JO  7PMHFOTJOUFSOFBGTQSBBLXPSEFOQBUJqOUFONFUFFOPQQFSWMBLLJH NJEDPSE5BDBSDJ OPPN JO FFSTUF JOTUBOUJF NFU MBTFSDIJSVSHJF CFIBOEFME )JFSCJK XPSEU FFO IPHF MPDBMF DPOUSPMF  FOMBSZOYQSFTFSWBUJF  HF[JFO%FSFTUFSFOEFQBUJqOUFOEJFPNSFEFO WBO TUFNCFIPVE NFU SBEJPUIFSBQJF XPSEFO CFIBOEFME IFCCFO FFO SFMBUJFG TMFDIUF VJU LPNTU MPLBMFDPOUSPMFFOMBSZOYQSFTFSWBUJF 0NXJMMFWBOEFJOEJDBUJFCJBTPQ CBTJTWBOUVNPSHSPPUUFLVOOFOEF[FUXFFHSPFQFOOJFUSFDIUTUSFFLTXPSEFOWFSHFMFLFO &DIUFS EFVJULPNTUWPPSCFTUSBBMEFQBUJqOUFOJTJOEF[FTUVEJFPPLPOHVOTUJH [FMGTXBO OFFS[FXPSEFOWFSHFMFLFONFUEFHFNJEEFMEFVJULPNTUOBSBEJPUIFSBQJFJOHSPUFTFSJFT POHFTFMFDUFFSEF5HMPUUJTDIMBSZOYDBSDJOPNFO*OUFHFOTUFMMJOHUPUPO[FCFWJOEJOHFOJO IPPGETUVL XBBSUVNPSHSPPUUF HFEF¾OJFFSEBMTIFUBBOUBMBBOHFEBOFWBOEFTUFN CBOE  OJFU BMT QSPHOPTUJTDIF GBDUPS LPO XPSEFO CFTUFNQFME  DPODMVEFSFO XJK VJU EF[F CFWJOEJOHFOEBUUVNPSHSPPUUFXBBSTDIJKOMJKLXFMFFOCFMBOHSJKLFQSPHOPTUJTDIFGBDUPSJT FOEBUEFIVJEJHF5/.DMBTTJ¾DBUJFIJFSPOWPMEPFOEFSFLFOJOHNFFIPVEU7FSEFSPOEFS [PFLJTOPEJHWPPSFFOPQUJNBMFEF¾OJUJFFOJOEFMJOHWBOUVNPSHSPPUUFCJK5HMPUUJTDI MBSZOYDBSDJOPPN%BBSOBBTUPOUTUBBU HF[JFOEFSFMBUJFGTMFDIUFSFTVMUBUFOWBOCFTUSBMJOH  EFWSBBHPWFSFFONPHFMJKLFSPMWPPSMBTFSDIJSVSHJFCJKEFHSPUFSF5MBFTJFT POEBOLTIFU FWFOUVFMFFGGFDUPQEFGVODUJPOBMJUFJU TUFN  )PPGETUVL  JT FFO SFUSPTQFDUJFWF DPIPSUTUVEJF NFU BMT EPFM UF POEFS[PFLFO PG FS FFO ²UZQJTDI³TUFNQSP¾FMHFEF¾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uOUFHSFFSE TUFNQSP¾FM%F&-4DPODMVEFFSUPPL[FMGEBUIVOIVJEJHFNVMUJEJNFOTJPOFMFQSPUPDPM WPPSTUFNBOBMZTFOJFUBMTIFUVMUJFNFNFFUJOTUSVNFOUWPPSEFTUFNCFTDIPVXENBHXPS EFOFOEBUEFPOUXJLLFMJOHWBOOJFVXFFONFFSWFS¾KOEFNFFUUFDIOJFLFOBBOHFNPFEJHE NPFUXPSEFO8JKTMVJUFOPOTBBOCJKEFHFEBDIUFEBUFSBLPFTUJTDIFQBSBNFUFSTPOUXJL LFMENPFUFOXPSEFOEJFEFPCKFDUJFWFBGXJKLJOHFOJOEFTUFNCFUFSXFFSHFWFO(F[JFO EF TMFDIUF JOUFS FO JOUSBSBUFS CFUSPVXCBBSIFJE WBO EF TVCKFDUJFWF CFPPSEFMJOHFO WBO [PXFMQFSDFQUJFWFTUFNBGXJKLJOHFOBMTTUSPCPTDPQJTDIFCFFMEFO[VMMFOIJFSWPPSOJFVXF. .

(7) CFPPSEFMJOHTNFUIPEFONPFUFOXPSEFOPOUXJLLFME[PEBUTUFNEFTLVOEJHFOVJUFJOEFMJKL LMJOJTDI SFMFWBOUF FO CFUSPVXCBSF HFuOUFHSFFSEF TUFNQSP¾FMFO LVOOFO EJTUJMMFSFO EJF WFSWPMHFOTWPPSCFHFMFJEJOHWBOQBUJqOUFOFOPVUDPNFPOEFS[PFLHFCSVJLULVOOFOXPS EFO%FEJTDSFQBOUJFUVTTFOQFSDFQUJFWFBOBMZTF LXBMJUFJU FOEFFJHFOCFPPSEFMJOHWBO EFQBUJqOU JNQBDU JTCJKVJUTUFLJOUFSFTTBOU)FUGFJUEBUEFFSOTUWBOEFTUFNBGXJKLJOH CJKQFSDFQUJFWFBOBMZTFOJFUQFSEF¾OJUJFPWFSFFOLPNUNFUEFFSOTUWBOEF[FMGCFMFFGEF IBOEJDBQCJKEFQBUJqOU FOIFUGFJUEBUEFCFMFFGEFIBOEJDBQCJKEF[FQPQVMBUJFNJOJNBBM JT [PVTVHHFSFSFOEBUFSSVJNUFJTPNJOEFUPFLPNTUHSPUFSFSFTFDUJFTVJUUFWPFSFO. . )PPGETUVL  JT EF FFSTUF WFSHFMJKLFOEF SFUSPTQFDUJFWF DPIPSUTUVEJF WBO TUFNLXBMJUFJU OB TVCFQJUIFMJBMFTVCMJHBNFOUBJSF MBTFS SFTFDUJF UZQF * PG ** &-4  FO SBEJPUIFSBQJF CJK WFS HFMJKLCBSF5B²NJEDPSE³MBFTJFT0NEJUUFCFSFJLFOXFSEHFCSVJLUHFNBBLUWBOFFOIJT UPSJTDIFDPOUSPMFHSPFQ SBEJPUIFSBQJF 4UFNNFOXFSEFOCFPPSEFFMENFUFFONVMUJEJ NFOTJPOFFMQSPUPDPM (3#"4 BLPFTUJTDIFFOBqSPEZOBNJTDIFBOBMZTF TUSPCPTDPQJFFO 7)* %FIFMGUWBOEFQBUJqOUFOWFSUPPOEFFFOMJDIUFUPUNBUJHFTUFNBGXJKLJOHPOBGIBO LFMJKLWBOEFCFIBOEFMNPEBMJUFJU0PLXFSEHFFOTUBUJTUJTDIWFSTDIJMHFWPOEFOUVTTFOEF CFJEFHSPFQFOWPPSXBUCFUSFGUIFUUZQFFOEFFSOTUWBOEFTUFNBGXJKLJOHFO IPFXFMFSXFM BBOXJK[JOHFO[JKOEBUIFUQFSDFQUJFWFTUFNQSP¾FMWPPSEFTUFNOBMBTFSDIJSVSHJFBOEFST [BM [JKO EBO EF TUFN OB SBEJPUIFSBQJF /B CFTUSBMJOH XBSFO TUFNNFO FFSEFS TDIPS FO OBMBTFSCFIBOEFMJOHXBSFOTUFNNFOFFSEFSIFFT0O[FCFWJOEJOHFO POEFSTUFVOEEPPS EFCFTDIFJEFOUSFOEJOEFMJUFSBUVVS EPFUPOTDPODMVEFSFOEBUMBTFSDIJSVSHJFFOCFTUSB MJOHWFSHFMJKLCBSFTUFNLXBMJUFJUPQMFWFSFOCJKQBUJqOUFONFUPQQFSWMBLLJH5B²NJEDPSE³ DBSDJOPPN%BBSEFPODPMPHJTDIFVJULPNTUFOWFSHFMJKLCBBS[JKO FOMBTFSDIJSVSHJFOPH EFBBOWVMMFOEFWPPSEFMFOIFFGUWBOFFOLPSUFSFCFIBOEFMJOHTEVVS MBHFSFLPTUFOnOEF NPHFMJKLIFJEUPUIFSIBBMEFCFIBOEFMJOHFO [JKOXJKWBONFOJOHEBUFOEPTDPQJTDIFMBTFS SFTFDUJFJONJEEFMTEnUIFSBQJFWBOWPPSLFVSJTCJKEF[FMBFTJFT )PPGETUVLJTFFOSFWJFXWBOEFMJUFSBUVVSPQIFUHFCJFEWBO5HMPUUJTDIMBSZOYDBSDJOPPN UPUKBOVBSJ6JUEF[FSFWJFXDPODMVEFSFOXJKEBUFSXFJOJHWFSTDIJMJOMPLBMFDPO USPMF JT UVTTFO EF UXFF NPEBMJUFJUFO MBTFS FO SBEJPUIFSBQJF  PPL WPPS POHFTFMFDUFFSEF MBFTJFT %JU CFUSFGU FDIUFS EF PWFSBMM VJULPNTUFO "EFRVBUF TUSBUJ¾DBUJF WPPS UVNPS HSPPUUFVJUCSFJEJOHJTWPPSBMTOPHOJFUNPHFMJKLEPPSEFUFLPSULPNJOHFOWBOEFIVJEJHF DMBTTJ¾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qOU[FMGFSWBBSU%F[FJTWBBLHFSJOH PPLXBOOFFS IFUSFTFDUJFTWBONFFSVJUHFCSFJEFMBFTJFTCFUSFGU&SJTHSPUFCFIPFGUFBBONFFSWFSHF.

(8) %VUDITVNNBSZ/FEFSMBOETFTBNFOWBUUJOH. MJKLFOEF EBUB PWFS EF GVODUJPOFMF SFTVMUBUFO TUFN  OB MBTFS FO SBEJPUIFSBQJF WBO NFFS VJUHFCSFJEF5MBFTJFT )PPGETUVLSBQQPSUFFSUPWFSFFOMBOEFMJKLFFORVpUFHFIPVEFOJOBMMF/FEFSMBOETFIPPGE IBMTXFSLHSPFQFOPNEFNFOJHWBOEF/FEFSMBOETFIPPGEIBMTDIJSVSHFOUFOBBO[JFOWBO MBTFSDIJSVSHJF CJK VJUHFCSFJEF 5 MBFTJFT UF JOWFOUBSJTFSFO 5XFF UZQFO SFTFDUJFT CMFLFO JO BBONFSLJOH UF LPNFO BMT NPHFMJKLF VJUCSFJEJOH PQ EF IVJEJHF SJDIUMJKO PQQFSWMBL LJHF CJMBUFSBMF SFTFDUJFT UZQF * FO ** &-4  FO EJFQF VOJMBUFSFMF SFTFDUJFT UZQF *** &-4  &DIUFS EFFORVpUFUPPOEFPPLEBUPOEBOLTEBUNFOFWFOUVFFMCFSFJEJTPNEF[FSFTFDUJFT CVJUFO EF IVJEJHF SJDIUMJKO VJU UF WPFSFO  IFU OJFU CFUFLFOU EBU NFO CFSFJE JT PN EF[F MBFTJFTJOUSJBMWFSCBOEUFSBOEPNJTFSFO%JUXFSEOPHFFOTEVJEFMJKLUPFOEFSFTVMUBUFO WBOEF[FFORVpUFHFQSFTFOUFFSEXFSEFOCJKEFKBBSMJKLTFXFUFOTDIBQTWFSHBEFSJOHWBOEF /FEFSMBOETF 8FSLHSPFQ )PPGE)BMT 5VNPSFO /8))5  JO EFDFNCFS  %F BMHF NFOFDPOTFOTVTCJKEF[FCFTQSFLJOHXBTEBUIPPGEIBMTDIJSVSHFOOPHTUFFETUFSVHIPV EFOE[JKOUFOBBO[JFOWBOIFUPQPGGFSFOWBOTUFNLXBMJUFJUCJKNFFSVJUHFCSFJEFSFTFDUJFT 5PUEBUNFFSCFXJKTUFOBBO[JFOWBOEFPODPMPHJTDIFFOGVODUJPOFMFSFTVMUBUFOCFTDIJL CBBSJT XPSEUMBTFSDIJSVSHJF°CFIBMWFCJKPQQFSWMBLLJHFNJEDPSE5BMBFTJFT°BMTFFO BMUFSOBUJFWFCFIBOEFMJOHTNFUIPEFCFTDIPVXEEJFBMMFFOJOHFTFMFDUFFSEFMBFTJFT OBVJU HFCSFJEPWFSMFHNFUEFQBUJqOULBOXPSEFOUPFHFQBTU)FUXFSWFOWBOQBUJqOUFOWPPSFFO HFSBOEPNJTFFSEFUSJBMJOVJUHFCSFJEF5MBFTJFTMJKLUEFSIBMWFPQEJUNPNFOUOJFUNPHF MJKL JO /FEFSMBOE 8JK WFSXJK[FO IJFSCJK OBBS IFU MBBUTUF IPPGETUVL WBO EJU QSPFGTDISJGU ²3FDPNNFOEBUJPOTGPSGVSUIFSSFTFBSDI³WPPSPOTWPPSTUFMIPFNFUEJUQSPCMFFNPNUF HBBO )PPGETUVLCFWBUEFDPODMVTJFWBOEJUQSPFGTDISJGU0O[FCFWJOEJOHFOPOEFSTUFVOFOEF IVJEJHFSJDIUMJKO²#FIBOEFMJOH-BSZOYDBSDJOPPN³XBBSJOMBTFSDIJSVSHJFBMTUIFSBQJFWBO LFV[FCJKIFUPQQFSWMBLLJH5BNJEDPSEDBSDJOPPNXPSEUBBOHFNFSLU%BBSOBBTUXPS EFOEFEJMFNNBµTCJKEFCFIBOEFMJOHWBOEFHSPUFSF5MBFTJFTVJUFFOHF[FU#JKEF[FMBF TJFTJTOPHOJFUEVJEFMJKLPGMBTFSEBOXFMSBEJPUIFSBQJFEFWPPSLFVSNPFUHFOJFUFO%F NPFJMJKLFBGXFHJOHUVTTFOPODPMPHJTDIFSFTVMUBUFO MBSZOYQSFTFSWBUJF FOFS[JKET XBBSJO MBTFSXBBSTDIJKOMJKLFFOWPPSEFFMIFFGUFOTUFNLXBMJUFJUBOEFS[JKET XBBSJOSBEJPUIFSBQJF XBBSTDIJKOMJKLFFOWPPSEFFMIFFGU LBOOPHOJFUWPMEPFOEFEVJEFMJKLXPSEFOHFNBBLU%F PPS[BLFOWBOEFIVJEJHFJNQBTTF[JKOEFPOEVJEFMJKLIFJEPWFSEFSFMFWBOUFQSPHOPTUJTDIF GBDUPSFO EFUFLPSULPNJOHFOWBOEFIVJEJHFUVNPSDMBTTJ¾DBUJFTZTUFNFOFOIFUPOUCSF LFOWBOGVODUJPOFMF TUFN EBUB%F[FXPSEFOWFSEFSUPFHFMJDIU5FOTMPUUFXPSEFOPPL TVHHFTUJFTHFEBBOWPPSUPFLPNTUJHPOEFS[PFLPQEJUHFCJFE. .

(9) .

(10)

Referenties

GERELATEERDE DOCUMENTEN

%JTDVTTJPO 5IJTTUVEZSFQPSUTPOUSFBUNFOUSFTVMUTBOEQSPHOPTUJDGBDUPSTGPSMPDBMDPOUSPMJOBMBSHF QPQVMBUJPOCBTFE TFSJFT PG DPOTFDVUJWF QBUJFOUT USFBUFE GPS 5 HMPUUJD DBSDJOPNB

XJUI B TJHOJ¾DBOU EFDSFBTF JO PWFSBMM TVSWJWBM 33 Q JOEFQFOEFOU PG BHF TVCTFRVFOU UVNPST UVNPSTUBHF HFOEFS BOE OPONBMJHOBOU DPNPSCJEJUZ 5IJT FGGFDU SFNBJOFE

.PSFJOUFSFTUJOHMZ UIFPVUDPNFGPSPVSJSSBEJBUFE5BQBUJFOUTJTBMTPQPPSFSUIBOUIF BWFSBHFPVUDPNFSFQPSUFEGPS VOTFMFDUFE 5QBUJFOUTUSFBUFEXJUISBEJPUIFSBQZJOUIF MJUFSBUVSF

1BUJFOUT 'SPN 0DUPCFS QBUJFOUT XJUI FBSMZ HMPUUJD DBODFS 5JT5 XJUI TJOHMF NJEDPSE

MBSZOYQSFTFSWBUJPO GPSNPSFFYUFOEFE5MFTJPOTUSFBUFEXJUISBEJPUIFSBQZ TFF DIBQUFS

5IFDVSSFOU%VUDIHVJEFMJOFDPOTJEFSTMBTFSTVSHFSZUIFUSFBUNFOUPGDIPJDFGPSTVQFS ¾DJBM 5B NJEDPSE MFTJPOT SFRVJSJOH B UZQF * PS ** SFTFDUJPO 5IF SFTVMUT PG UIJT

$IBQUFSJTBQPQVMBUJPOCBTFE SFUSPTQFDUJWFDPIPSUTUVEZPGUIFSJTLPGTZODISPOPVTBOE NFUBDISPOPVTUVNPSTJOQBUJFOUTXJUI5JT5HMPUUJDDBSDJOPNB*UTIPXTUIBUPCTFSWFE UPFYQFDUFE SBUJPT JO NBMFT

are you prepared to sacrifice voice quality/function if this would mean reduced laryngectomy rates for the group as a whole. ‰ yes ‰