Supraglottic squamous cell carcinomas have distinctive clinical features and prognosis based on subregion.

Weiquan Ding,Guorong Zou,Tingbao Hu,Shaoyun Cui,Tianrun Liu,Ankui Yang,Weiwei Cai,Jiangang Liang,Gabriele Multhoff

doi:10.1371/journal.pone.0188322

Abstract

ObjectiveTo analyze the clinicopathologic characteristics and prognosis of patients with squamous cell carcinoma localized to different supraglottic subregions.MethodsClinicopathologic data were reviewed retrospectively for 111 patients with supraglottic squamous cell carcinoma who were diagnosed between January 1, 1995 and December 31, 2005 and were initially treated with surgery. DNA from human papillomavirus (HPV) 16 and (or /and) HPV 18 were detected in all the 111 supraglottic carcinoma specimens using in situ hybridization. Survival analysis was performed by Kaplan-Meier analysis, factors were compared using log-rank test, and prognostic factors were determined using Cox proportional hazards model. The relationship between subregions and clinicopathologic factors was analyzed using Chi-square tests.ResultsHPV prevalence differed between patients with aryepiglottic fold carcinoma and ventricle carcinoma (P < .05). The local-regional control rates, overall survival rates or cancer specific survival rates were significantly different between different subregions. Univariate analysis indicated that pTNM classification, pN spread, and subregion were associated with prognosis (P < .05). Multivariate analysis indicated that pTNM classification and subregion were associated with supraglottic carcinoma prognosis. The survival rate was better for patients with carcinoma of the epiglottis or ventricular bands compared to those with carcinoma in the aryepiglottic fold or ventricle (P = .012).ConclusionsSubregion may be a new prognostic factor for supraglottic squamous cell carcinoma. Different supraglottic carcinoma subregions have distinct clinical features such as HPV expression, lymph node metastasis rate, local-regional control and prognosis. Therefore, it is necessary to subdivide supraglottic squamous cell carcinomas into several subregion groups to individualize therapy.

Highlights

Laryngeal carcinoma is one of the most common malignancies of the head and neck [1, 2].Supraglottic carcinoma is the dominant laryngeal tumor, especially in some developing countries where alcohol and smoking are the most common risk factors [2, 3]
human papillomavirus (HPV) prevalence differed between patients with aryepiglottic fold carcinoma and ventricle carcinoma (P < .05)
Multivariate analysis indicated that pTNM classification and subregion were associated with supraglottic carcinoma prognosis

Summary

Introduction

Laryngeal carcinoma is one of the most common malignancies of the head and neck [1, 2].Supraglottic carcinoma is the dominant laryngeal tumor, especially in some developing countries where alcohol and smoking are the most common risk factors [2, 3]. Patients with supraglottic carcinoma often present with non-specific throat pain, dysphagia, and neck lymphadenopathy as the primary disease features. These patients tend to present for care at an advanced stage and have poor overall survival [4, 5]. The supraglottic laryngeal region includes the epiglottis, ventricular bands, aryepiglottic fold (laryngeal aspect), and laryngeal ventricle, each of which serves a distinct anatomic purpose [6]. Until now, it has been unclear whether clinical features and prognosis differ based on carcinoma subregion

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Conclusion