Abstract
ObjectivesTo investigate the most important factors affecting the prognosis of the patients with squamous cell carcinoma (SCC) of the larynx.MethodsBased on the clinical and follow-up data, 205 patients with SCC of the larynx receiving total laryngectomy, partial laryngectomy, or CO2 laser surgery in GuangDong General Hospital were retrospectively analyzed. A survival analysis was performed by the Kaplan-Meier method and a multivariable analysis of prognostic factors was carried out using the Cox proportional hazard model.ResultsSubtypes of carcinoma included 69.8% glottic and 30.2% supraglottic. Most patients were in N0 stage (77.6%), and 22.4% patients were in N1∼N3 stage. Over half of the patients were in T1∼T2 stage (55.1%), 20.0% in T3, and 24.9% in T4. Mean follow-up duration was 49.2 months. The survival rates 1, 2, and 3 years after the surgery were 99.0%, 91.7%, and 81.5%, respectively. The survival rate for those patients with clinical stage IV was significantly lower than for those with clinical stage I and II (p<0.001 and p = 0.013, respectively). The disease-free progression rates 1, 2, and 3 years after the surgery were 83.9%, 74.6%, and 71.2%, respectively. Futhermore, those patients with a Charlson score of 1 to 2 and ≥3 had higher risk of mortality than those with a Charlson score of 0 (hazard ratios of 1.8 and 2.41 p = 0.042 and p = 0.008). Multivariable analysis revealed that clinical stage, surgical margin, and comorbidity were significantly associated with both mortality and disease-free progression.ConclusionThe surgical resection margin, clinical stage, and comorbidity were independent factors affecting the laryngeal cancer prognosis. The survival rates were lower for patients with advanced laryngeal cancer, positive surgical margins, or severe comorbidity, suggesting the importance of early diagnosis, early treatment, negative surgical margins, and conditions of comorbidity.
Highlights
Laryngeal cancer is a malignant disease with high incidence and it accounts for about 2.4% of all newly diagnosed malignancies worldwide each year [1].With the continuous industrialization in China, the prevalence has gradually increased in this country to about 2 to 4/100, 000 [2]
The survival rate of laryngocarcinoma patients has been demonstrating a decreasing trend the survival of patients with other cancers has been prolonged to different extents [6]
Baseline Characteristics During the study period from January 2003 to November 2008, 301 patients with laryngeal carcinoma were hospitalized, with 96 of them being excluded from the study according to the exclusion criteria
Summary
Laryngeal cancer is a malignant disease with high incidence and it accounts for about 2.4% of all newly diagnosed malignancies worldwide each year [1].With the continuous industrialization in China, the prevalence has gradually increased in this country to about 2 to 4/100, 000 [2]. It is generally believed that the occurrence of laryngeal cancer may be related to alcohol consumption, tobacco use, air pollution, sex hormones, and occupational factors [3,4,5]. The survival rate of laryngocarcinoma patients has been demonstrating a decreasing trend (from 57.1% to 51.9%) the survival of patients with other cancers has been prolonged to different extents [6]. Understanding the prognostic factors for patients after laryngeal cancer surgery may reverse the trend toward a decreased rate of survival and greatly help to improve both the treatment strategies and the survival rate of patients. The prognostic factors are currently still controversial [6], and they require further study
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