title: Recurrent laryngeal squamous cell carcinoma: rTNM versus composite laryngeal recurrence staging system. Proposal for a modification of the CLRSS to improve patient classification.
abstract: BACKGROUND
  Based on the initial TNM stage of the tumor and the extension of recurrence, the composite laryngeal recurrence staging system (CLRSS) has been proposed as an alternative to the rTNM system for staging patients with recurrent laryngeal carcinoma. The objective of our study was to carry out an external validation of the CLRSS, and to evaluate a modified version of the original CLRSS, that we named CLRSS-2.
  
  
  METHODS
  We conducted a retrospective analysis of 332 patients with recurrent laryngeal carcinoma treated in our center between 1985 and 2003.
  
  
  RESULTS
  rTNM, CLRSS, and CLRSS-2 showed a monotonic prognostic gradient with increasing stage and produced significant differences in survival between stages. Discrepancies were detected in the cross-tabulation between rTNM and CLRSS. The CLRSS-2 achieved the best results in an objective comparison of the staging systems evaluated.
  
  
  CONCLUSIONS
  The CLRSS-2 was the best method to classify patients with a recurrent laryngeal carcinoma.
authors.affiliation: Department of Otolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain. xleon@hsp.santpau.es
authors.forename: Xavier
authors.initials: X
authors.lastname: León
authors.forename: Montserrat
authors.initials: M
authors.lastname: López
authors.forename: Jacinto
authors.initials: J
authors.lastname: García
authors.forename: Ignacio
authors.initials: I
authors.lastname: Viza
authors.forename: Ignasi
authors.initials: I
authors.lastname: Gich
authors.forename: Miquel
authors.initials: M
authors.lastname: Quer
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D007825:Laryngectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging / Q000145:classification* / Q000379:methods*; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate