[Treatment and prognosis of stage III-IV laryngeal squamous cell carcinoma].
OBJECTIVE
Laryngeal squamous cell carcinoma (LSCC) is a common malignancy of the head and neck. Stage I-II LSCC patients have a favorable prognosis after operation or radiotherapy, but the curative effect and prognosis of stage III-IV LSCC are not satisfying, and its treatment is also controversial. This study was to summarize our experience in treating stage III-IV LSCC patients, evaluate the treatment results, and seek more reasonable therapeutic modality.


METHODS
Records of 202 stage III-IV LSCC patients, treated in Cancer Center of Sun Yat-sen University from Jan. 1, 1991 to Jan. 1, 2000, were retrospectively analyzed. Of the 202 patients, 64 received surgery alone, 83 received surgery and preoperative or postoperative radiotherapy, 41 received radiotherapy, and 14 received chemotherapy. The overall survival rate was estimated using life table method by SPSS10.0 software. Survival curves were compared with Wilcoxon method; relapse statuses were compared with Chi(2) test.


RESULTS
The 5- and 10-year overall survival rates of the 202 patients was (42.12+/-3.62)% and (33.20+/-4.32)%, and the median survival time was 48.5 months. The 5-year survival rates were 61.07% in glottic carcinoma group and 26.07% in supraglottic carcinoma group, and were 53.41% in surgery alone group, 51.04% in surgery plus radiotherapy group, 18.33% in radiotherapy group and 7.14% in chemotherapy group. There was no significant difference between surgery alone group and surgery plus radiotherapy group (P>0.05). Of the 147 patients received surgery, the 5-year survival rates were 56.15% for the 31 patients received partial laryngectomy and 52.08% for the 116 patients received total laryngectomy. Eleven patients had tumor relapsed after total laryngectomy within 5 years.


CONCLUSIONS
Surgery, especially total laryngectomy, is the major treatment modality for stage III-IV LSCC. Partial laryngectomy may be performed with strict selection. Postoperative radiotherapy may be preformed on the patients with suspect of tumor residue or positive margin.
Tian
Wen-Dong
WD
State Key Laboratory of Oncology in Southern China, Guangzhou, Guangdong 510060, P. R. China.
Zeng
Zong-Yuan
ZY
Chen
Fu-Jin
FJ
Wu
Guo-Hao
GH
Guo
Zhu-Ming
ZM
Zhang
Quan
Q
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D001761:Bleomycin; D002945:Cisplatin; D005472:Fluorouracil