Department of Head and Neck Surgery, Instituto Central, University of Sao Paulo Medical School, 8° andar. Cerqueira César, São Paulo, 05403-000, Brazil.
Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil.
Eur Arch Otorhinolaryngol. 2021 May;278(5):1627-1635. doi: 10.1007/s00405-020-06438-1. Epub 2020 Oct 23.
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.
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.
The mean TV was 23.0 ± 16.4 cm. A cutoff point for TV of 14.2 cm 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 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).
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.
TNM 肿瘤分期系统是最常用于喉癌的系统。然而，在相同的 T 分期中，可能会发现具有不同原发肿瘤体积（TV）的病变，这会影响治疗结果。
分析了 2008 年至 2017 年期间接受手术治疗的 145 例国际抗癌联盟（UICC）T3 和 T4a 喉癌患者。收集 TV 测量值并与不同的结果进行比较。
平均 TV 为 23.0±16.4cm。确定了 TV 为 14.2cm 的截断点。累积样本 5 年总生存率（OS）为 62.1%，5 年无病生存率（DFS）为 65.5%。在单因素分析中，TV≥14.2cm 与远处转移的风险增加相关（p=0.045），OS（p=0.009）和 DFS（p=0.035）的降低率更高。在多因素分析中，TV 不是DFS（p=0.569）或 OS（p=0.094）更差的独立危险因素。
在接受手术治疗的晚期喉癌患者中，原发肿瘤 TV 与复发和生存不良的发生率呈显著相关，在单因素分析中，TV 可作为这些患者有前途的预后指标。
