Wilkie M D, Lightbody K A, Pinto R, Tandon S, Jones T M, Lancaster J
Department of Otorhinolaryngology - Head & Neck Surgery, University Hospital Aintree, Liverpool, UK.
Liverpool Cancer Research Centre, Department of Molecular & Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
Clin Otolaryngol. 2015 Dec;40(6):610-5. doi: 10.1111/coa.12421.
The TNM classification system for squamous cell carcinoma (SCC) of the head and neck neglects to incorporate volumetric analysis of the primary tumour. Tumour volume (TV) has been implicated prognostically in laryngeal SCC treated by primary radiotherapy (RT), but data for patients treated surgically are lacking. We evaluated such for glottic SCCs resected by transoral laser microsurgery (TLM).
Retrospective cohort study utilising TVs calculated as the product of tumour resection dimensions and time-to-event analyses using the Kaplan-Meier method. The prognostic ability of variables was estimated using log-rank statistics, univariate Cox regression and receiver-operating characteristics analysis where appropriate.
Tertiary referral head and neck cancer centre.
Patients undergoing primary TLM for glottic SCC with curative intent (2007-2011) with at least 12 months follow-up data.
Prognostic impact of TV on local control (LC), overall survival (OS) and disease-specific survival (DSS).
Eligible patients (n = 129) had a median follow-up of 40 months (range 14-79 months). Median TV for all cases was 300 mm(3) (range 2-19800 mm(3)). Three-year LC, OS and DSS were 92%, 92% and 98%, respectively. Tumour volume was not a significant predictor of any oncological outcome measure. Otherwise, a significant influence of pT stage on DSS was observed and of age on OS.
In contrast to laryngeal SCC treated by RT, TV does not appear to portend oncological outcome in glottic SCC managed specifically by TLM and consequently does not warrant incorporation into current prognostic models for such patients.
头颈部鳞状细胞癌（SCC）的TNM分类系统未纳入原发肿瘤的体积分析。肿瘤体积（TV）在接受根治性放疗（RT）的喉鳞状细胞癌的预后中具有重要意义，但缺乏手术治疗患者的数据。我们评估了经口激光显微手术（TLM）切除的声门型SCC的肿瘤体积。
回顾性队列研究，利用肿瘤切除尺寸的乘积计算肿瘤体积，并采用Kaplan-Meier方法进行事件发生时间分析。在适当的情况下，使用对数秩统计、单变量Cox回归和受试者操作特征分析来评估变量的预后能力。
三级转诊头颈癌中心。
2007年至2011年接受根治性TLM治疗声门型SCC且有至少12个月随访数据的患者。
肿瘤体积对局部控制（LC）、总生存（OS）和疾病特异性生存（DSS）的预后影响。
符合条件的患者（n = 129）中位随访时间为40个月（范围14 - 79个月）。所有病例的中位肿瘤体积为300 mm³（范围2 - 19800 mm³）。三年局部控制率、总生存率和疾病特异性生存率分别为92%、92%和98%。肿瘤体积不是任何肿瘤学结局指标的显著预测因素。此外，观察到pT分期对疾病特异性生存有显著影响，年龄对总生存有显著影响。
与接受放疗的喉鳞状细胞癌不同，肿瘤体积似乎不能预示经TLM专门治疗的声门型SCC的肿瘤学结局，因此不值得纳入此类患者当前的预后模型。
