Tumor volume as a predictor of survival in advanced laryngeal cancer treated with total laryngectomy

Head Neck. 2023 Jun;45(6):1376-1388. doi: 10.1002/hed.27351. Epub 2023 Apr 3.

Abstract

Background: Recent literature shows that tumor volume (TV) in T3 laryngeal squamous cell carcinoma (LSCC) is associated with response to radiation therapy. The aim of this study was to evaluate the effect of TV on survival outcomes in patients undergoing total laryngectomy (TL).

Methods: One hundred and seventeen patients with LSCC undergoing TL between 2013 and 2020 at the University of Florida were included. TV was measured using a previously validated method on preoperative-CT scans. Multivariable CoxPH models for overall survival (OS) and disease-specific survival (DSS), metastasis-free survival (MFS), and recurrence-free survival (RFS) were developed with TV.

Results: Mean age was 61.5 years and 81.2% were male. Higher TV was associated with decreased OS, MFS, DSS, and RFS with adjusted hazard ratios 1.02 (95%CI: 1.01, 1.03), 1.01, (95%CI: 1.00, 1.03), 1.03 (95%CI: 1.01, 1.06), and 1.02 (95%CI: 1.00, 1.03) respectively. TV >7.1 cc had worse prognoses.

Conclusions: TV appears associated with decreased survival in LSCC treated with TL.

Keywords: laryngeal cancer; laryngectomy; radiation therapy; survival outcomes; tumor volume.

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Female
  • Head and Neck Neoplasms* / pathology
  • Humans
  • Laryngeal Neoplasms* / pathology
  • Laryngectomy / methods
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Tumor Burden