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Tumor volume as a predictor of survival in T3 glottic carcinoma: A novel approach to patient selection
•T3 glottic cancers
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| Published in: | Oral oncology 2018-04, Vol.79, p.47-54 |
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| Main Authors: | , , , , , , , , |
| Format: | Article |
| Language: | English |
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| cites | cdi_FETCH-LOGICAL-c446t-b84ecf2ac88a240333612ae9f31b92dd6b750cb520ae2fd5b2a74671a377832b3 |
| container_end_page | 54 |
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| container_title | Oral oncology |
| container_volume | 79 |
| creator | Dziegielewski, Peter T. Reschly, William J. Morris, Chris G. DeJesus, Reordan Danny Silver, Natalie Boyce, Brian J. Santiago, Inocente Amdur, Robert J. Mendenhall, William M. |
| description | •T3 glottic cancers |
| doi_str_mv | 10.1016/j.oraloncology.2018.02.015 |
| format | article |
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The optimal treatment for T3 glottic cancers continues to be debated. Organ preservation has become the standard of care, but not all tumors respond equally. The purpose of this was to investigate the long-term survival outcomes of organ preservation protocols based on tumor volume.
A retrospective review of prospectively collected data from 1966 to 2016 was performed. Patients with T3 vocal cord cancer treated with radiation therapy (RT) at the University of Florida were included. Local control rates as well as survival rates were determined with a Kaplan Meier and Cox regression analysis. Survival was analyzed as a function of tumor volume and an optimal cut point was determined.
107/234 patients were included. 79% received RT and 21% chemo-RT. 5-year local control was 61.5% and 5-year disease specific survival was 79.3%. Tumor volume was a significant predictor of survival (p = 0.007). An optimal cut point for tumor volume was 2.5 cc. Patients with tumor volumes ≥2.5 cc had significantly worse (p < 0.05) tumor control rates (100% vs. 70.4%).
Tumor volume is a significant predictor of survival outcomes in T3 vocal cord cancers, but will need external validation. Tumors <2.5 cc have favorable outcomes. Those with higher volume tumors should be counselled appropriately and be considered for primary surgical management.</description><identifier>ISSN: 1368-8375</identifier><identifier>EISSN: 1879-0593</identifier><identifier>DOI: 10.1016/j.oraloncology.2018.02.015</identifier><identifier>PMID: 29598950</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Glottis - pathology ; Humans ; Laryngeal cancer ; Laryngeal Neoplasms - drug therapy ; Laryngeal Neoplasms - pathology ; Laryngeal Neoplasms - radiotherapy ; Laryngeal Neoplasms - surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Radiation therapy ; Retrospective Studies ; Survival outcomes ; T3 glottic carcinoma ; Total laryngectomy ; Tumor Burden ; Tumor volume</subject><ispartof>Oral oncology, 2018-04, Vol.79, p.47-54</ispartof><rights>2018 Elsevier Ltd</rights><rights>Copyright © 2018 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-b84ecf2ac88a240333612ae9f31b92dd6b750cb520ae2fd5b2a74671a377832b3</citedby><cites>FETCH-LOGICAL-c446t-b84ecf2ac88a240333612ae9f31b92dd6b750cb520ae2fd5b2a74671a377832b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29598950$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dziegielewski, Peter T.</creatorcontrib><creatorcontrib>Reschly, William J.</creatorcontrib><creatorcontrib>Morris, Chris G.</creatorcontrib><creatorcontrib>DeJesus, Reordan Danny</creatorcontrib><creatorcontrib>Silver, Natalie</creatorcontrib><creatorcontrib>Boyce, Brian J.</creatorcontrib><creatorcontrib>Santiago, Inocente</creatorcontrib><creatorcontrib>Amdur, Robert J.</creatorcontrib><creatorcontrib>Mendenhall, William M.</creatorcontrib><title>Tumor volume as a predictor of survival in T3 glottic carcinoma: A novel approach to patient selection</title><title>Oral oncology</title><addtitle>Oral Oncol</addtitle><description>•T3 glottic cancers <2.5 cc have an 81% control rate with RT/CRT.•T3 glottic cancers ≥2.5 cc have 33% higher recurrence rate.•37% T3 glottic cancers treated with RT/CRT had a locoregional recurrence.•Total laryngectomy + RT provides better survival for T3 glottic cancers ≥2.5 cc.
The optimal treatment for T3 glottic cancers continues to be debated. Organ preservation has become the standard of care, but not all tumors respond equally. The purpose of this was to investigate the long-term survival outcomes of organ preservation protocols based on tumor volume.
A retrospective review of prospectively collected data from 1966 to 2016 was performed. Patients with T3 vocal cord cancer treated with radiation therapy (RT) at the University of Florida were included. Local control rates as well as survival rates were determined with a Kaplan Meier and Cox regression analysis. Survival was analyzed as a function of tumor volume and an optimal cut point was determined.
107/234 patients were included. 79% received RT and 21% chemo-RT. 5-year local control was 61.5% and 5-year disease specific survival was 79.3%. Tumor volume was a significant predictor of survival (p = 0.007). An optimal cut point for tumor volume was 2.5 cc. Patients with tumor volumes ≥2.5 cc had significantly worse (p < 0.05) tumor control rates (100% vs. 70.4%).
Tumor volume is a significant predictor of survival outcomes in T3 vocal cord cancers, but will need external validation. Tumors <2.5 cc have favorable outcomes. Those with higher volume tumors should be counselled appropriately and be considered for primary surgical management.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Glottis - pathology</subject><subject>Humans</subject><subject>Laryngeal cancer</subject><subject>Laryngeal Neoplasms - drug therapy</subject><subject>Laryngeal Neoplasms - pathology</subject><subject>Laryngeal Neoplasms - radiotherapy</subject><subject>Laryngeal Neoplasms - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local</subject><subject>Radiation therapy</subject><subject>Retrospective Studies</subject><subject>Survival outcomes</subject><subject>T3 glottic carcinoma</subject><subject>Total laryngectomy</subject><subject>Tumor Burden</subject><subject>Tumor volume</subject><issn>1368-8375</issn><issn>1879-0593</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNqNkMFu1TAQRS1ERUvhF5DFik3C2I6TuLuqUECq1M1jbU0cp_jJiYPtROrf4-qViiWrGY3unTtzCPnIoGbA2s_HOkT0YTHBh4fHmgPra-A1MPmKXLC-UxVIJV6XXrR91YtOnpO3KR0BQDIJb8g5V1L1SsIFmQ7bHCLdg99mSzFRpGu0ozO5TMNE0xZ3t6OnbqEHQR98yNkZajAat4QZr-g1XcJuPcV1jQHNL5oDXTE7u2SarLcmu7C8I2cT-mTfP9dL8vP26-Hme3V3_-3HzfVdZZqmzdXQN9ZMHE3fI29ACNEyjlZNgg2Kj2M7dBLMIDmg5dMoB45d03YMRdf1gg_iknw67S23_N5synp2yVjvcbFhS5oDh0Y1jRJFenWSmhhSinbSa3QzxkfNQD9x1kf9L2f9xFkD14VzMX94ztmG2Y4v1r9gi-DLSWDLt7uzUSdTkJiCNhYkegzuf3L-AMCGlsQ</recordid><startdate>201804</startdate><enddate>201804</enddate><creator>Dziegielewski, Peter T.</creator><creator>Reschly, William J.</creator><creator>Morris, Chris G.</creator><creator>DeJesus, Reordan Danny</creator><creator>Silver, Natalie</creator><creator>Boyce, Brian J.</creator><creator>Santiago, Inocente</creator><creator>Amdur, Robert J.</creator><creator>Mendenhall, William M.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201804</creationdate><title>Tumor volume as a predictor of survival in T3 glottic carcinoma: A novel approach to patient selection</title><author>Dziegielewski, Peter T. ; Reschly, William J. ; Morris, Chris G. ; DeJesus, Reordan Danny ; Silver, Natalie ; Boyce, Brian J. ; Santiago, Inocente ; Amdur, Robert J. ; Mendenhall, William M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-b84ecf2ac88a240333612ae9f31b92dd6b750cb520ae2fd5b2a74671a377832b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Glottis - pathology</topic><topic>Humans</topic><topic>Laryngeal cancer</topic><topic>Laryngeal Neoplasms - drug therapy</topic><topic>Laryngeal Neoplasms - pathology</topic><topic>Laryngeal Neoplasms - radiotherapy</topic><topic>Laryngeal Neoplasms - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local</topic><topic>Radiation therapy</topic><topic>Retrospective Studies</topic><topic>Survival outcomes</topic><topic>T3 glottic carcinoma</topic><topic>Total laryngectomy</topic><topic>Tumor Burden</topic><topic>Tumor volume</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dziegielewski, Peter T.</creatorcontrib><creatorcontrib>Reschly, William J.</creatorcontrib><creatorcontrib>Morris, Chris G.</creatorcontrib><creatorcontrib>DeJesus, Reordan Danny</creatorcontrib><creatorcontrib>Silver, Natalie</creatorcontrib><creatorcontrib>Boyce, Brian J.</creatorcontrib><creatorcontrib>Santiago, Inocente</creatorcontrib><creatorcontrib>Amdur, Robert J.</creatorcontrib><creatorcontrib>Mendenhall, William M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Oral oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dziegielewski, Peter T.</au><au>Reschly, William J.</au><au>Morris, Chris G.</au><au>DeJesus, Reordan Danny</au><au>Silver, Natalie</au><au>Boyce, Brian J.</au><au>Santiago, Inocente</au><au>Amdur, Robert J.</au><au>Mendenhall, William M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tumor volume as a predictor of survival in T3 glottic carcinoma: A novel approach to patient selection</atitle><jtitle>Oral oncology</jtitle><addtitle>Oral Oncol</addtitle><date>2018-04</date><risdate>2018</risdate><volume>79</volume><spage>47</spage><epage>54</epage><pages>47-54</pages><issn>1368-8375</issn><eissn>1879-0593</eissn><abstract>•T3 glottic cancers <2.5 cc have an 81% control rate with RT/CRT.•T3 glottic cancers ≥2.5 cc have 33% higher recurrence rate.•37% T3 glottic cancers treated with RT/CRT had a locoregional recurrence.•Total laryngectomy + RT provides better survival for T3 glottic cancers ≥2.5 cc.
The optimal treatment for T3 glottic cancers continues to be debated. Organ preservation has become the standard of care, but not all tumors respond equally. The purpose of this was to investigate the long-term survival outcomes of organ preservation protocols based on tumor volume.
A retrospective review of prospectively collected data from 1966 to 2016 was performed. Patients with T3 vocal cord cancer treated with radiation therapy (RT) at the University of Florida were included. Local control rates as well as survival rates were determined with a Kaplan Meier and Cox regression analysis. Survival was analyzed as a function of tumor volume and an optimal cut point was determined.
107/234 patients were included. 79% received RT and 21% chemo-RT. 5-year local control was 61.5% and 5-year disease specific survival was 79.3%. Tumor volume was a significant predictor of survival (p = 0.007). An optimal cut point for tumor volume was 2.5 cc. Patients with tumor volumes ≥2.5 cc had significantly worse (p < 0.05) tumor control rates (100% vs. 70.4%).
Tumor volume is a significant predictor of survival outcomes in T3 vocal cord cancers, but will need external validation. Tumors <2.5 cc have favorable outcomes. Those with higher volume tumors should be counselled appropriately and be considered for primary surgical management.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>29598950</pmid><doi>10.1016/j.oraloncology.2018.02.015</doi><tpages>8</tpages></addata></record> |
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| ispartof | Oral oncology, 2018-04, Vol.79, p.47-54 |
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| source | ScienceDirect Journals |
| subjects | Adult Aged Aged, 80 and over Combined Modality Therapy Female Glottis - pathology Humans Laryngeal cancer Laryngeal Neoplasms - drug therapy Laryngeal Neoplasms - pathology Laryngeal Neoplasms - radiotherapy Laryngeal Neoplasms - surgery Male Middle Aged Neoplasm Recurrence, Local Radiation therapy Retrospective Studies Survival outcomes T3 glottic carcinoma Total laryngectomy Tumor Burden Tumor volume |
| title | Tumor volume as a predictor of survival in T3 glottic carcinoma: A novel approach to patient selection |
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