Tumor volumetry as a prognostic factor in the management of T4a laryngeal cancer

Authors

  • Li-Jen Hsin MD,

    1. Department of Otolaryngology, Head and Neck Surgery, Taoyuan, Taiwan
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  • Tuan-Jen Fang MD,

    Corresponding author
    1. Department of Otolaryngology, Head and Neck Surgery, Taoyuan, Taiwan
    • Send correspondence to Tuan-Jen Fang, MD, Department of Otolaryngology, Chang Gung Memorial Hospital, No. 5, Fuxing street, Guishan 33305, Taoyuan, Taiwan. E-mail: fang3109@cgmh.org.tw

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  • Ngan-Ming Tsang MD,

    1. Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taiwan
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  • Shy-Chyi Chin MD,

    1. Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taiwan
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  • Tzu-Chen Yen MD, PhD,

    1. Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taiwan
    2. Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
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  • Hsueh-Yu Li MD, FACS,

    1. Department of Otolaryngology, Head and Neck Surgery, Taoyuan, Taiwan
    2. Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taiwan
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  • Chun-Ta Liao MD,

    1. Department of Otolaryngology, Head and Neck Surgery, Taoyuan, Taiwan
    2. Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taiwan
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  • I-How Chen MD

    1. Department of Otolaryngology, Head and Neck Surgery, Taoyuan, Taiwan
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  • Presented at the 8th East Asia Conference on Phonosurgery, Jeju, Republic of Korea, on November 30–December 1, 2012.

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

The role of tumor volume in T4a laryngeal cancer remains unclear among different treatment modalities. Using tumor volumetry, we investigated the impact of primary tumor volume on this subset of patients.

Study Design

Retrospective cohort study of 62 T4a laryngeal cancer patients.

Methods

From October 2002 to September 2010, 48 patients were treated with definitive chemoradiation therapy (CRT), and 14 patients had undergone total laryngectomy. Tumor volume was calculated and was correlated with the overall survival (OS), progression-free survival (PFS), and local control rate (LCR) data of each treatment group.

Results

The 5-year OS, PFS, and LCR were significantly lower in the CRT group with tumor volume ≥ 15 cm3 (22.5% vs. 48.7%, P = 0.009; 32.2% vs. 64.3%, P = 0.003; 45.2% vs. 67.3%, P = 0.039). Multivariate analysis showed that tumor volume was an independent poor prognosticator for OS, PFS, and LCR in the CRT group. For tumor volume ≥ 15 cm3, total laryngectomy provided a significantly higher 5-year OS and PFS (54.5% vs. 22.5%, P = 0.039; 80.0% vs. 32.2%, P = 0.017) than for those tumors treated with definitive CRT.

Conclusions

Patients with T4a laryngeal cancer with primary tumor volume ≥ 15 cm3 had poorer survival outcomes after definitive CRT compared with total laryngectomy. It was also an independent poor prognosticator on LCR, PFS, and OS for those receiving definitive CRT. For patients with tumor volume ≥ 15 cm3, total laryngectomy provided a better survival outcome than definitive CRT.

Level of Evidence

4. Laryngoscope, 124:1134–1140, 2014

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