Association between pathological differentiation and survival outcomes of patients with laryngeal squamous cell carcinoma.

Abstract

To investigate the prognostic value of histopathological differentiation for the survival of patients with laryngeal squamous cell carcinoma (LSCC). Retrospective clinical and histopathological differentiation data on consecutive cases of LSCC from a single institution over a 10-years period were collected and analyzed in this study. Oncological outcomes were assessed based on disease-specific survival (DSS), disease-free survival (DFS), and overall survival (OS) using the Kaplan-Meier method and Cox proportional hazards regression analysis. Propensity score matching (PSM) was performed to reduce or eliminate the bias due to confounding variables. A total of 998 LSCC cases were identified in this study. As compared to well to moderately differentiated LSCC, poorly differentiated tumors had adjusted hazard ratios (aHRs) of 1.78 (95% confidence interval [CI] 1.31-2.43), 2.00 (95% CI 1.51-2.65), and 1.72 (95% CI 1.28-2.31) for DSS, DFS, and OS, respectively. The new patient cohort consisted of 138 patients with well to moderately differentiated LSCC and 138 patients with poorly differentiated LSCC after PSM. The survival outcomes of patients with well to moderately differentiated LSCCs were significantly better than those of patients with poorly differentiated tumors in DSS (aHR 1.91; 95% CI 1.24-2.95), DFS (aHR 2.07; 95% CI 1.37-3.12), and OS (aHR 2.14; 95% CI 1.39-3.28). This study showed that survival outcomes of patients with poorly differentiated LSCC were significantly worse than those of patients with well to moderately differentiated LSCC. In addition, histopathological differentiation is an important prognostic factor for LSCC survival. Therefore, further treatment plans should focus on poorly differentiated LSCC to improve the survival outcomes.