[Clinical characteristics and multivariate analysis of prognostic factors in recurrent laryngeal carcinoma].
OBJECTIVE
The recurrence is an important factor affecting the prognosis of laryngeal carcinoma. There are few reports on the clinical characteristics and the prognostic factors of recurrent laryngeal carcinoma. The purpose of this study was to analyze the clinical features and prognostic factors of recurrent laryngeal carcinoma.


METHODS
The data of 80 patients with recurrent laryngeal carcinoma between 1990 and 1997 were retrospectively investigated. Survival analysis was performed by Kaplan-Meier method; comparison among/between groups was performed using log-rank test; multivariate analysis was carried out using Cox proportional hazard model.


RESULTS
The recurrence sites included locoregional recurrence, neck lymph node and distant metastases. The 3-year and 5-year overall survival rates for patients with recurrent laryngeal carcinoma were 50.6% and 34.6%, respectively. The 5-year disease-specific survival rates for the patients treated with surgery, surgery + radiotherapy, and surgery +chemotherapy (30 cases) was 73%. The recurrence of laryngeal carcinoma were developed within 1-156 months, the median time of recurrence was 11 months; there were 36 locoregional recurrence, 36 neck lymph node recurrence, 4 locoregional recurrence associated with neck lymph node recurrence, 1 locoregional recurrence associated with distant metastases, 3 neck lymph node recurrence associated with distant metastases. Univariate analysis revealed that the factors impacting the prognosis were recurrent site, duration of recurrence gaps, treatment modality of recurrence, and age (P< 0.05). The neck lymph node recurrence group, peristomal recurrence group, distant metastases group, radiotherapy and chemotherapy after recurrence group had a poorer prognosis than locoregional recurrence group, larynx recurrence group, without distant metastases group, and surgery group (P< 0.05). Multivariate analysis showed that age > or =60 years old, duration of recurrence gap < 12 months, distant metastases and radiotherapy or chemotherapy modality after recurrence were independently associated with decreased survival rates (P< 0.05).


CONCLUSIONS
Surgery or surgery dominated multi-modality therapy was the principal treatment modality for recurrence laryngeal carcinoma. Age > or =60 years old, duration of recurrence gap < 12 months, distant metastases and salvage therapy by radiotherapy and chemotherapy but not surgery were independent factors affecting the prognosis.
Chen
Yan-Feng
YF
Department of Head and Neck Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, PR China.
Chen
Fu-Jin
FJ
Yang
An-Kui
AK
Zeng
Zong-Yuan
ZY
Song
Ming
M
Li
Qiu-Li
QL
D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D007825:Laryngectomy / Q000379:methods; D008175:Lung Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D011379:Prognosis; D016016:Proportional Hazards Models; D015996:Survival Rate