Prognostic factors in laryngeal carcinoma. A multifactorial study of 416 cases.

The prognostic significance of 20 clinical and histologic parameters was evaluated in a series of 416 laryngeal carcinomas treated between 1969 and 1981 at the Hospital de Santa Cruz y San Pablo, Barcelona, Spain. Clinical follow-up ranged from 2 to 13 years. The variables considered were: age, smoking habits, previous laryngeal disease, duration of clinical symptoms, motility of vocal cords, interval between diagnosis and treatment, postoperative infection, topographic location of the tumor, previous tracheostomy, ulceration, tumor size, resection margins, histologic grading, patterns of growth, types of invasion, mitotic index, depth of invasion, positive lymph nodes, T categories and N categories. Fourteen parameters were found to be significantly related to survival. After a multifactorial study using Cox's life table regression model, 5 of those 14 parameters were found to influence survival independently. The five variables ordered according to prognostic significance were: (1) positive lymph nodes, (2) T categories, (3) histologic grading, (4) ulceration, and (5) location.