Prognostic determinants in supraglottic carcinoma: Univariate and Cox regression analysis

Nicolai, Piero; Zinis, Luca Oscar Redaelli de; Tomenzoli, Davide; Barezzani, Maria Grazia; Bertoni, F.; Bignardi, Mario; Antonelli, A.

doi:10.1002/(sici)1097-0347(199707)19:4<323::aid-hed11>3.0.co;2-a

Cited by 42 publications

(33 citation statements)

References 56 publications

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“…Several authors found the microscopic appearance of the Table 6 Cox proportional hazard analysis of prognostic factors for treatment outcome in 1 252 patients with laryngeal squamous cell carcinoma treated with radical radiotherapy. The analysis included 1 124 patients for whom all listed parameters were available, the enter method was used tumor as significant for both local control (27,28) and survival (17,29). Duration of treatment was the treatment-linked prognostic feature, as Raitiola et al (30) demonstrated a better survival time in patients undergoing short therapy in early glottic carcinomas.…”

Section: Acta Oncologica 42 (2003)mentioning

confidence: 99%

Laryngeal Carcinoma Multivariate Analysis of Prognostic Factors in 1 252 Consecutive Patients Treated with Primary Radiotherapy

2003

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Section: Acta Oncologica 42 (2003)mentioning

confidence: 99%

Laryngeal Carcinoma Multivariate Analysis of Prognostic Factors in 1 252 Consecutive Patients Treated with Primary Radiotherapy

2003

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“…6 To avoid the substantial risk of delayed detection and treatment, 7,8 elective neck dissection has been recommended for cN0 patients with a tumor invasion depth of 4 mm or greater. 9 Neck dissection provides nearly definitive information about nodal metastasis.…”

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confidence: 99%

Gene Expression Analysis As a Tool in Early-Stage Oral Cancer Management

Mroz

Rocco

2012

JCO

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Elective neck dissection for clinically stage N0 (cN0) disease has been called the gold standard in the management of early-stage oral squamous cell cancer (OSCC), despite advances in imaging technologies and the recent application of sentinel lymph node mapping. 1Approximately 30% of patients with cN0 disease have nodal metastasis found by pathology (pNϩ), [1][2][3][4][5] with poor prognosis, particularly if there is extracapsular spread. 6 To avoid the substantial risk of delayed detection and treatment, 7,8 elective neck dissection has been recommended for cN0 patients with a tumor invasion depth of 4 mm or greater.9 Neck dissection provides nearly definitive information about nodal metastasis. If no positive nodes are found, there is little risk of regional recurrence.5-10 Elective neck dissection alone can often represent sufficient treatment for early-stage disease, while guiding the use of adjuvant radiation and chemotherapy when indicated. Nevertheless, with approximately 70% of cN0 cases also pN0, elective neck dissection raises concern over unnecessary surgery and its associated morbidity.11 Thus, some clinicians instead recommend watchful waiting, hoping to detect and treat any nodal metastasis quickly, 2 whereas others argue that the potential therapeutic benefit of neck dissection outweighs the risk of morbidity.1 Consequently, interest in solving this clinical treatment dilemma has prompted continued investigation into novel ways to improve the management of the cN0 neck in early-stage OSCC.In the article that accompanies this editorial, van Hooff et al 12 report major advances toward a primary-tumor RNA expression signature to help in this choice. With a laboratory-made microarray, this group had previously identified genes whose expression levels in primary oral-cavity tumors were related to nodal metastasis. 13,14 They now have moved their analysis platform to a commercial microarray in a Clinical Laboratory Improvement Amendments/International Organization for Standardization-approved laboratory, finding a gene-expression signature-score cutoff in a "platform transition" cohort that provided 92% negative predictive value in cT1-T2N0 cases (ie, 92% of cases with negative expression signatures were actually metastasis free, based on pathologic evaluation of the neck dissection). They then used that signature cutoff to classify a "validation" cohort of 222 specimens from eight institutions, finding 89% negative predictive value and 86% assay sensitivity for detecting pNϩ cases. Major challenges, however, remain in incorporating these promising technical results into clinical practice.A major reason for Van Hooff et al's successful extension of earlier findings to the more clinically relevant setting of their study is the large number of diagnostic genes-696 genes, with a total of 732 microarray probe sequences-whose primary-tumor expression levels were used quantitatively. The risk of nodal metastasis for each patient was gauged by how closely each of its 732 expression values matched the correspo...

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“…However, patients with extensive cartilage invasion, tongue base involvement, compromised airways and supraglottic subsite are considered poor candidates for a function sparing approach. 9,17 The LFS for the whole group at 5 years in our series was 47%. These results are marginally inferior to laryngeal preservation rates of CRT treatment arms of large randomized trials.…”

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confidence: 47%

Concomitant Chemoradiation in Locally Advanced Laryngeal Cancer

Jamshed¹,

Hussain²,

Jamshed³

et al. 2010

International Journal of Head and Neck Surgery

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Introduction: Despite the acceptance of concomitant chemoradiation (CRT) as an alternative to total laryngectomy (TL) in locally advanced laryngeal cancer (LALC), laryngeal preservation is sparingly recommended in developing countries. We report on prognostic factors and survival in T3/T4 laryngeal cancer treated with concomitant CRT at Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH and RC) to provide comparison with other geographic locations.

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Prognostic determinants in supraglottic carcinoma: Univariate and Cox regression analysis

Cited by 42 publications

References 56 publications

Laryngeal Carcinoma Multivariate Analysis of Prognostic Factors in 1 252 Consecutive Patients Treated with Primary Radiotherapy

Laryngeal Carcinoma Multivariate Analysis of Prognostic Factors in 1 252 Consecutive Patients Treated with Primary Radiotherapy

Gene Expression Analysis As a Tool in Early-Stage Oral Cancer Management

Concomitant Chemoradiation in Locally Advanced Laryngeal Cancer

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