Tumor volume as a prognostic factor of locally advanced laryngeal cancer

• Published in: European archives of oto-rhino-laryngology 2021-05, Vol.278 (5), p.1627-1635
• Main Authors: de Andrade, Natália Martins Magacho, Dedivitis, Rogério Aparecido, Ramos, Daniel Marin, Matos, Leandro Luongo, Garcia, Marcio Ricardo Taveira, Conti, Gustavo Gonçalves, Kowalski, Luiz Paulo
• Format: Article
• Language: English
• Subjects: Disease-Free Survival; Head and Neck; Head and Neck Surgery; Humans; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - surgery; Medicine; Medicine & Public Health; Neoplasm Recurrence, Local - epidemiology; Neoplasm Staging; Neurosurgery; Otorhinolaryngology; Prognosis; Retrospective Studies; Tumor Burden
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-020-06438-1

Purpose The TNM tumor staging system is the most widely used for laryngeal cancer. However, in the same T stage, lesions with different primary tumor volumes (TV) can be found, impacting treatment outcomes. Methods 145 patients with T3 and T4a laryngeal cancer, according to Union for International Cancer Control, who underwent surgical treatment from 2008 to 2017, were analyzed. TV measurements were collected and compared to different outcomes. Results The mean TV was 23.0 ± 16.4 cm 3 . A cutoff point for TV of 14.2 cm 3 was established. Cumulative sample 5-year overall survival (OS) was 62.1%, while 5-years disease-free survival (DFS) was 65.5%. In univariate analysis, TV ≥ 14.2 cm 3 was associated with a higher risk of distant metastases ( p  = 0.045), and worse rates of OS ( p  = 0.009) and DFS ( p  = 0.035). In multivariate analysis, TV was not an independent risk factor of worse DFS ( p  = 0.569) or OS ( p  = 0.094). Conclusion Primary lesion TV showed significant association, in univariate analysis, with worse rates of recurrence and survival in advanced laryngeal cancer undergoing surgical treatment and can be a promising prognostic for these patients.