Tumor volume: an independent predictor of outcome for laryngeal cancer.
OBJECTIVE
Other studies have shown a relationship between the volume of laryngeal tumors and local control when treated with radiation therapy. Our purpose was to determine the relationship between tumor volume, clinical staging, and several histologic abnormalities to local control in patients treated with initial surgery.


METHODS
Tumor volume was calculated from pretreatment CT scans in 52 patients with squamous cell carcinoma treated surgically. The presence of perineural and lymphatic spread as well as cartilage and vessel invasion were obtained from histology. All cases had at least a 2 year clinical follow-up after initial surgery. Statistical analysis consisted of Mantel-Haneszel chi2-tests and Fisher exact test.


RESULTS
Local control rate was 92%. Tumor volume and cartilage invasion were associated with local control (p < 0.05). Local control rate for tumors with volumes of < 16 cm3 was 98% compared with 40% for tumors with volumes of > 16 cm3 (p < 0.05). Evidence of cartilage invasion was associated with increased likelihood of local recurrence. There was no significant association between local control and perineural, vascular, or lymphatic tumor spread. We found a marginally significant association between clinical T-stage and local control (p = 0.05).


CONCLUSIONS
Pretreatment CT volumes are useful in predicting local control in laryngeal carcinoma treated with surgery. Of the histologic features studied, only cartilage invasion was significant in predicting tumor control.
Department of Radiology, University of North Carolina, Chapel Hill, USA.
S K
SK
Mukherji
S M
SM
O'Brien
R J
RJ
Gerstle
M
M
Weissler
W
W
Shockley
M
M
Castillo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome