Wpływ wybranych czynników kliniczno-morfologicznych na wyniki leczenia chorych z zawansowanym rakiem krtani

Abstract

IntroductionThe aim of the study was to indicate independent prognostic factors of treatment in group of patients with advanced cancer of the larynx. Material and methodThe paper presents results of univariate and multivariate analysis of selected clinical and morphological factors in the group of 355 patients with advanced laryngeal cancer treated in the ENT Clinical Department in Zabrze in the following years 1998–2007. The analysis of the results of treatment in relation to clinical and morphological features of the tumor was based on overall survival, disease-free survival, local control and locoregional control. The results of analysis allowed to indicate the independent prognostic factors for outcome in patients with advanced laryngeal cancer. ResultsUnivariate analysis showed that the increase of clinical advancement of laryngeal cancer was associated with worse prognosis, as well as the fact that the primary location of the tumor in supraglottis and infiltration in laryngeal part of pharynx determined the worse outcome. Univariate and multivariate analysis confirmed that the number of lymph node metastases in the surgical specimen and microscopic radical of surgery were the most important prognostic factors for survival and cure in the study group. ConclusionThe strongest independent prognostic significance for all efficacy criteria have: completeness of operation and number of metastatic lymph nodes.