Retrospective Analysis of Prognostic Factors in 205 Patients with Laryngeal Squamous Cell Carcinoma Who Underwent Surgical Treatment

Abstract

ObjectivesTo investigate the most important factors affecting the prognosis of the patients with squamous cell carcinoma (SCC) of the larynx.MethodsBased on the clinical and follow-up data, 205 patients with SCC of the larynx receiving total laryngectomy, partial laryngectomy, or CO2 laser surgery in GuangDong General Hospital were retrospectively analyzed. A survival analysis was performed by the Kaplan-Meier method and a multivariable analysis of prognostic factors was carried out using the Cox proportional hazard model.ResultsSubtypes of carcinoma included 69.8% glottic and 30.2% supraglottic. Most patients were in N0 stage (77.6%), and 22.4% patients were in N1∼N3 stage. Over half of the patients were in T1∼T2 stage (55.1%), 20.0% in T3, and 24.9% in T4. Mean follow-up duration was 49.2 months. The survival rates 1, 2, and 3 years after the surgery were 99.0%, 91.7%, and 81.5%, respectively. The survival rate for those patients with clinical stage IV was significantly lower than for those with clinical stage I and II (p<0.001 and p = 0.013, respectively). The disease-free progression rates 1, 2, and 3 years after the surgery were 83.9%, 74.6%, and 71.2%, respectively. Futhermore, those patients with a Charlson score of 1 to 2 and ≥3 had higher risk of mortality than those with a Charlson score of 0 (hazard ratios of 1.8 and 2.41 p = 0.042 and p = 0.008). Multivariable analysis revealed that clinical stage, surgical margin, and comorbidity were significantly associated with both mortality and disease-free progression.ConclusionThe surgical resection margin, clinical stage, and comorbidity were independent factors affecting the laryngeal cancer prognosis. The survival rates were lower for patients with advanced laryngeal cancer, positive surgical margins, or severe comorbidity, suggesting the importance of early diagnosis, early treatment, negative surgical margins, and conditions of comorbidity.

Treatment results, side effects and prognostic factors affecting survival in patients with larynx cancer

“…[23] Similarly, the 3-year overall survival rates in the current study was 69% for all patients, 83% for early-stage, and 61% for late-stage disease .…”

A genetic view of laryngeal cancer heterogeneity

“…In general, the supra and subglottic cancers have worse prognosis than glottic cancers, which 5-year survival is 82% for early stages possibly related to early detection. 15 Moreover, PS, 12,16 node invasion 16,17 and localization 12 are prognostic factors for disease-free survival in conjunction with pathologic stage (pT), 17 surgical resection margins 16 and pretreatment tracheotomy. 18 Moreover, T4 primary extension and more than 2 cm tumoral invasion of the base of the tongue were shown to be associated with increased salvage laryngectomy in the Veterans study.…”

Current cancer stem cell biomarkers in laryngeal cancer

“…CD44+/CD133+ cells obtained from human laryngeal primary carcinoma cells exhibited elevated levels of beta1-integrin (also known as CD29) [24]. Its expression was also significantly associated with cervical lymph node metastasis, T stage, and histologic differentiation [68].…”

“…When CD44 and CD133 positive cells (CD44+/CD133+) were injected to mice, they produced significantly larger tumors compared to those produced from other cell populations. CD44+/CD133+ cells, with stronger invasive potential, were also found to express several other stem cell markers [24]. In a recent study, Suer et al [21] investigated the CSC potential of CD133+ cells isolated from freshly resected LCa specimens and found that CD133+ cells strongly express stemness genes such as SOX2, OCT4 and KLF4.…”