TUMOR VOLUME AS A PREDICTOR OF SURVIVAL IN ADVANCED LARYNGEAL CANCER TREATED WITH TOTAL LARYNGECTOMY
Submitted by:
Krishna Hanubal
University of Florida College of Medicine
Presenter(s):
Krishna S. Hanubal
Peter T. Dziegielewski
Abstract
Recent literature shows that tumor volume in T3 laryngeal cancer (LC) can predict response to radiation therapy. Patients with tumors > 2.5cc have inferior long-term disease-free status and require increased rates of salvage laryngectomy. The effect of tumor volume on survival after primary surgery is unknown. The aim of this study was to determine to the effect of tumor volume on survival outcomes in patients undergoing primary and salvage total laryngectomy (TL). Patients with LC undergoing primary or salvage TL were included. Prospective data base was used to extract patient data and preoperative CT-scans. 2 radiologists reviewed each scan to determine tumor volume by an established protocol. Survival outcomes were determined by Kaplan-Meier and Cox-regression analysis. 117 patients were included. 3 (2.6%) had T1-T2 disease, 41 (35%) had T3 disease, 72 (61.5%) had T4 disease and 1 (0.9%) had unknown T stage. Average tumor volume was 22.6cc with a median of 17.3cc (range: 1.8-166cc). Higher tumor volume was positively correlated with Body Mass Index (BMI) and smoking history. Higher tumor volume, BMI, Charlson Comorbidity Index (CCI), and perineural invasion (PNI) were found to decrease overall survival (p
Objectives
Increased preoperative tumor volume decreases overall survival in advanced glottic cancer
Age, BMI, CCI, nodal stage, and PNI also impact survival outcomes
Tumor volume may help individualize treatment in advanced glottic cancer
