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Clinical and histopathological prognostic factors in locoregional advanced laryngeal cancer

Published online by Cambridge University Press:  24 October 2016

T S Santos*
Affiliation:
Department of ENT, Instituto Português de Oncologia, Porto, Portugal Department of ENT, Hospital de São Sebastião, Santa Maria da Feira, Portugal
R Estêvão
Affiliation:
Department of ENT, Instituto Português de Oncologia, Porto, Portugal
L Antunes
Affiliation:
Department of Epidemiology, Instituto Português de Oncologia, Porto, Portugal
V Certal
Affiliation:
Department of ENT, Hospital de São Sebastião, Santa Maria da Feira, Portugal Center for Health Technology and Services Research (‘CINTESIS’), Oporto Medical School, University of Porto, Portugal
J C Silva
Affiliation:
Department of ENT, Instituto Português de Oncologia, Porto, Portugal
E Monteiro
Affiliation:
Department of ENT, Instituto Português de Oncologia, Porto, Portugal
*
Address for correspondence: Dr Tiago Soares Santos, Rua General Norton de Matos, 86 1°Ct, 4050-424 Porto, Portugal Fax: 00 351 227 344 603 E-mail: tssmed@gmail.com

Abstract

Objective:

To evaluate the clinical and histopathological factors affecting the prognosis of patients with squamous cell locoregional advanced laryngeal cancer.

Methods:

A retrospective chart review was conducted of 121 patients with locoregional advanced laryngeal cancer, primarily treated with surgery from 2007 to 2011. Disease-free survival and overall survival rates were analysed as oncological outcomes. Prognostic variables, namely gender, pharyngeal invasion, pathological assessment of tumour and nodal stage, adjuvant therapy, margin status, nodal extracapsular extension, tumour differentiation, lymphovascular and perineural invasion, and predominant growth pattern, were also analysed.

Results:

One-year and three-year disease-free survival rates were 81.3 per cent and 63.5 per cent, respectively. One-year and three-year overall survival rates were 88.3 per cent and 61.4 per cent, respectively. Multivariate analysis showed that nodal extracapsular extension (p < 0.05) and an infiltrative growth pattern (p < 0.05) were associated with disease progression. Nodal extracapsular extension (p < 0.05) was associated with higher mortality.

Conclusion:

Nodal extracapsular extension and an infiltrative growth pattern were the main prognostic factors in locoregional advanced laryngeal cancer. The presence of pharyngeal invasion, pathologically confirmed node-positive stage 2–3 disease, close or microscopic positive margins, and lymphovascular and perineural invasion have a negative impact on prognosis.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 American Cancer Society. Cancer Facts & Figures 2007. In: http://www.cancer.org/acs/groups/content/@nho/documents/document/caff2007pwsecuredpdf.pdf [25 March 2015]Google Scholar
2 Rodrigo, JP, López, F, Llorente, JL, Álvarez-Marcos, C, Suárez, C. Results of total laryngectomy as treatment for locally advanced laryngeal cancer in the organ-preservation era [in Spanish]. Acta Otorrinolaringol Esp 2015;66:132–8CrossRefGoogle ScholarPubMed
3 Starska, K, Kulig, A, Łukomski, M. Tumor front grading in prediction of survival and lymph node metastases in patients with laryngeal carcinoma. Adv Med Sci 2006;51:200–4Google Scholar
4 Skóra, T, Nowak-Sadzikowska, J, Mucha-Małecka, A, Szyszka-Charewicz, B, Jakubowicz, J, Gliński, B. Postoperative irradiation in patients with pT3-4N0 laryngeal cancer: results and prognostic factors. Eur Arch Otorhinolaryngol 2015;272:673–9Google Scholar
5 Pfister, DG, Ang, KK, Brizel, DM, Burtness, BA, Cmelak, AJ, Colevas, AD et al. Head and neck cancers. J Natl Compr Canc Netw 2011;9:596650 Google Scholar
6 Markou, K, Goudakos, J, Triaridis, S, Konstantinidis, J, Vital, V, Nikolaou, A. The role of tumor size and patient's age as prognostic factors in laryngeal cancer. Hippokratia 2011;15:7580 Google ScholarPubMed
7 Morales-Angulo, C, Val-Bernal, F, Buelta, L, Fernandez, F, García-Castrillo, L, Rama, J. Prognostic factors in supraglottic laryngeal carcinoma. Otolaryngol Head Neck Surg 1998;119:548–53Google ScholarPubMed
8 Pulkkinen, JO, Klemi, P, Martikainen, P, Grénman, R. Apoptosis in situ, p53, bcl-2 and AgNOR counts as prognostic factors in laryngeal carcinoma. Anticancer Res 1999;19:703–7Google Scholar
9 Cox, DR. Regression models and life tables. J R Stat Soc Series B 1972;34:187229 Google Scholar
10 Smee, RI, Katie, JD, Broadley, K, Williams, J. Prognostic factors for supraglottic cancer. Head Neck 2013;35:949–58CrossRefGoogle Scholar
11 Hinerman, RW, Morris, CG, Amdur, RJ, Lansford, CD, Werning, JW, Villaret, DB et al. Surgery and postoperative radiotherapy for squamous cell carcinoma of the larynx and pharynx. Am J Clin Oncol 2006;29:613–21CrossRefGoogle ScholarPubMed
12 Ramroth, H, Schoeps, A, Rudolph, E, Dyckhoff, G, Plinkert, P, Lippert, B et al. Factors predicting survival after diagnosis of laryngeal cancer. Oral Oncol 2011;47:1154–8CrossRefGoogle ScholarPubMed
13 Nguyen, TD, Malissard, L, Théobald, S, Eschwège, F, Panis, X, Bachaud, JM et al. Advanced carcinoma of the larynx: results of surgery and radiotherapy without induction chemotherapy (1980–1985): a multivariate analysis. Int J Radiat Oncol Biol Phys 1996;36:1013–18CrossRefGoogle ScholarPubMed
14 Nguyen-Tan, PF, Le, QT, Quivey, JM, Singer, M, Terris, DJ, Goffinet, DR et al. Treatment results and prognostic factors of advanced T3-4 laryngeal carcinoma: the University of California, San Francisco (UCSF) and Stanford University Hospital (SUH) experience. Int J Radiat Oncol Biol Phys 2001;50:1172–80Google Scholar
15 Kligerman, J, Olivatto, LO, Lima, RA, Freitas, EQ, Soares, JR, Dias, FL et al. Elective neck dissection in the treatment of T3/T4 N0 squamous cell carcinoma of the larynx. Am J Surg 1995;170:436–9CrossRefGoogle ScholarPubMed
16 Danic, D, Maruic, M, Uzarevic, B, Milicic, D. Prognostic factors in squamous cell carcinoma of the larynx. Am J Surg 1989;158:314–17Google Scholar
17 Welkoborsky, HJ, Hinni, M, Dienes, HP, Mann, WJ. Predicting recurrence and survival in patients with laryngeal cancer by means of DNA cytometry, tumor front grading, and proliferation markers. Ann Otol Rhinol Laryngol 1995;104:503–10Google Scholar
18 Pera, E, Moreno, A, Galindo, L. Prognostic factors in laryngeal carcinoma. A multifactorial study of 416 cases. Cancer 1986;58:928–34Google Scholar
19 Zhang, SY, Lu, ZM, Luo, XN, Chen, LS, Ge, PJ, Song, XH et al. Retrospective analysis of prognostic factors in 205 patients with laryngeal squamous cell carcinoma who underwent surgical treatment. PLoS One 2013;8:e60157 Google ScholarPubMed
20 Leemans, CR, Tiwari, R, Nauta, JJ, van der Waal, I, Snow, GB. Regional lymph node involvement and its significance in the development of distant metastases in head and neck carcinoma. Cancer 1993;71:452–63.0.CO;2-B>CrossRefGoogle ScholarPubMed
21 Maxwell, JH, Ferris, RL, Gooding, W, Cunningham, D, Mehta, V, Kim, S et al. Extracapsular spread in head and neck carcinoma: impact of site and human papillomavirus status. Cancer 2013;119:3302–8Google Scholar