Tumor Volume Staging Provides a Comparable Stratifying for Laryngeal Squamous Cell Cancer According to T Stages

Yılmaz Özkul; Akif İşlek; Asuman Feda Bayrak; Ecem Akdağ; Demet Etit

doi:10.1007/s12070-023-03522-w

Tumor Volume Staging Provides a Comparable Stratifying for Laryngeal Squamous Cell Cancer According to T Stages

Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):1344-1351. doi: 10.1007/s12070-023-03522-w. Epub 2023 Feb 13.

Authors

Yılmaz Özkul¹, Akif İşlek², Asuman Feda Bayrak¹, Ecem Akdağ¹, Demet Etit¹

Affiliations

¹ Department of Otorhinolaryngology, Izmir Katip Celebi University Medical Faculty, Izmir, Turkey.
² Otolaryngology-Head & Neck Surgery Clinic, Acibadem Eskişehir Hospital, Hoşnudiye Mah, Acıbadem Sk. No: 19, Tepebaşı, Eskişehir, Turkey.

PMID: 37636709
PMCID: PMC10447356 (available on 2024-09-01)
DOI: 10.1007/s12070-023-03522-w

Abstract

The prognostic significance of tumor volume (TV) in laryngeal squamous cell cancer (LSCC) has been demonstrated previously. Still, its clinical use is uncertain, and a method for accurate staging for TV is lacking. This study aimed to develop an objective staging and determine the effect of tumor volume on disease outcome after surgical treatment for LSCC. This study was designed retrospectively. Patients with LSCC who underwent laryngectomy were identified. Discretization for optimal scaling level of Tumor Volume (TV) was performed by Catreg Version 3.0. The rate of cancer recurrence, disease-free survival (DFS), and overall survival (OS) rate were calculated and compared between T stage and TV staging. Kaplan-Meier survival analysis was performed for comparison. 206 LSCC patients enrolled in the study. TV was found significantly higher in patients with cartilage invasion, contralateral nodal metastasis, and extranodal extension (p = 0.004, 0.010, and 0.021, respectively). TV and lymph node density LND showed a low significant positive correlation (p = 0.015, r = 0.169). TV was 7.25 + 7.53 ml on average, and TV above the mean value was found to be an independent risk factor for OS and DFS (p = 0.043, HR = 1.8; CI95% for HR: 1.02-3.44 and p < 0.001, HR = 3.7; CI95% for HR: 1.8-7.3, respectively). The optimal scaling level of TV was found in three-level; group 1: TV ≤ 7.07, group 2: 7.07 < TV ≤ 14.09, and group 3: TV ≥ 14.10. This categorization of TV has obtained significant discretization between patients for DFS and OS (Long-Rank = 0.038 and < 0.001). This classification may provide better performance in addition to helping the T stage in determining prognosis, especially in patients with advanced laryngeal SCC.

Keywords: Laryngeal squamous cell cancer; Prognosis; TNM; Tumor volume.

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