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Tumor volume as a prognostic factor for local control and overall survival in advanced larynx cancer
Author(s) -
Timmermans Adriana J.,
Lange Charlotte A. H.,
de Bois Josien A.,
van Werkhoven Erik,
HammingVrieze Olga,
Hilgers Frans J. M.,
van den Brekel Michiel W. M.
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25567
Subject(s) - medicine , larynx , laryngectomy , chemoradiotherapy , radiation therapy , cancer , head and neck cancer , hazard ratio , retrospective cohort study , oncology , surgery , confidence interval
Objectives/Hypothesis Tumor volume has been postulated to be an important prognostic factor for oncological outcome after radiotherapy or chemoradiotherapy. This postulate was retrospectively investigated in a consecutively treated cohort of T3–T4 larynx cancer patients. Study Design Retrospective cohort study. Methods For 166 patients with T3–T4 larynx cancer (1999–2008), pretreatment computed tomography and magnetic resonance imaging scans were available for tumor volume delineation. Patients were treated with radiotherapy, chemoradiotherapy, or total laryngectomy with postoperative radiotherapy. Both a dedicated head and neck radiologist and the first author determined all tumor volumes. Statistical analysis was by Kaplan‐Meier plots and Cox proportional hazard models. Results Patients with T3 larynx cancer had significantly smaller tumor volumes than patients with T4 larynx cancer (median = 8.1 cm 3 and 15.8 cm 3 , respectively; P < .0001). In the group treated with total laryngectomy and postoperative radiotherapy, no association was found between tumor volume and local or locoregional control or overall survival. In the group treated with radiotherapy, a nonsignificant trend was observed between local control and tumor volume. In the chemoradiotherapy group, however, a significant impact of tumor volume was found on local control (hazard ratio = 1.07; 95% confidence interval = 1.01‐1.13; P = .028). Conclusions Tumor volume was not significantly associated with local control, locoregional control, or overall survival in the surgically treated group. In the group treated with radiotherapy, there was no statistically significant association, but a trend was observed between local control and tumor volume. Only in patients treated with concurrent chemoradiotherapy was a significant impact of tumor volume on local control found. Level of Evidence 4. Laryngoscope , 126:E60–E67, 2016