Clinical effect of postoperative chemoradiotherapy in resected advanced laryngeal squamous cell carcinoma

Abstract

Laryngeal squamous cell carcinoma (LSCC) is one of the most prevalent types of head and neck malignancies. Advanced LSCC has failed to demonstrate a satisfactory prognosis, despite the progresses in the diagnosis and treatment, and the optimal treatment modality continues to be debated. To evaluate the clinical utility and survival outcomes of adjuvant chemoradiotherapy (CRT) for patients with resected advanced LSCC, a retrospective analysis of 232 patients with LSCC who had undergone total laryngectomy and neck dissection between 2005 and 2010 was conducted. Of the 232 eligible patients, 167 patients (72%) received surgery alone, whereas 65 patients (28%) received surgery + adjuvant CRT. In the overall cohort, the 5-and 10-year overall survival (OS) rates were 55.2 and 48.3%, respectively. Multivariate analysis revealed that the clinical stage was significantly associated with OS. However, the N classification was an independent indicator in disease-free survival and laryngeal cancer-specific survival. In those patients with stage IV disease, patients receiving adjuvant CRT exhibited a markedly improved survival benefit compared with patients receiving surgical treatment only, following propensity score matching of the data (P<0.05). The application of adjuvant CRT confers additional survival benefits in comparison with surgery-only treatment regimens for advanced LSCC. However, additional prospective studies are required.

Predicting survival of advanced laryngeal squamous cell carcinoma: comparison of machine learning models and Cox regression models

“…According to NCCN guidelines, a remarkable amount of evidence showed significantly improved OS, disease-free survival, and locoregional control when a systemic therapy and radiation regimen (concomitant or, less commonly, sequential) was compared with RT alone for locoregionally advanced disease 16 . In a previous study, our research group reported that in patients with stage IV LSCC, those receiving adjuvant chemoradiotherapy exhibited a markedly improved survival benefit compared with patients receiving surgical treatment only 17 . Notably, in the present study, postoperative recovery time was identified as a significant variable in both the nomogram and RSF.…”