title: Retrospective analysis of prognostic factors in 205 patients with laryngeal squamous cell carcinoma who underwent surgical treatment.
abstract: OBJECTIVE
  To investigate the most important factors affecting the prognosis of the patients with squamous cell carcinoma (SCC) of the larynx.
  
  
  METHODS
  Based on the clinical and follow-up data, 205 patients with SCC of the larynx receiving total laryngectomy, partial laryngectomy, or CO2 laser surgery in GuangDong General Hospital were retrospectively analyzed. A survival analysis was performed by the Kaplan-Meier method and a multivariable analysis of prognostic factors was carried out using the Cox proportional hazard model.
  
  
  RESULTS
  Subtypes of carcinoma included 69.8% glottic and 30.2% supraglottic. Most patients were in N0 stage (77.6%), and 22.4% patients were in N1∼N3 stage. Over half of the patients were in T1∼T2 stage (55.1%), 20.0% in T3, and 24.9% in T4. Mean follow-up duration was 49.2 months. The survival rates 1, 2, and 3 years after the surgery were 99.0%, 91.7%, and 81.5%, respectively. The survival rate for those patients with clinical stage IV was significantly lower than for those with clinical stage I and II (p<0.001 and p = 0.013, respectively). The disease-free progression rates 1, 2, and 3 years after the surgery were 83.9%, 74.6%, and 71.2%, respectively. Futhermore, those patients with a Charlson score of 1 to 2 and ≥3 had higher risk of mortality than those with a Charlson score of 0 (hazard ratios of 1.8 and 2.41 p = 0.042 and p = 0.008). Multivariable analysis revealed that clinical stage, surgical margin, and comorbidity were significantly associated with both mortality and disease-free progression.
  
  
  CONCLUSIONS
  The surgical resection margin, clinical stage, and comorbidity were independent factors affecting the laryngeal cancer prognosis. The survival rates were lower for patients with advanced laryngeal cancer, positive surgical margins, or severe comorbidity, suggesting the importance of early diagnosis, early treatment, negative surgical margins, and conditions of comorbidity.
authors.affiliation: Department of Otorhinolaryngology, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China.
authors.forename: Si-Yi
authors.initials: SY
authors.lastname: Zhang
authors.forename: Zhong-Ming
authors.initials: ZM
authors.lastname: Lu
authors.forename: Xiao-Ning
authors.initials: XN
authors.lastname: Luo
authors.forename: Liang-Si
authors.initials: LS
authors.lastname: Chen
authors.forename: Ping-Jiang
authors.initials: PJ
authors.lastname: Ge
authors.forename: Xin-Han
authors.initials: XH
authors.lastname: Song
authors.forename: Shao-Hua
authors.initials: SH
authors.lastname: Chen
authors.forename: Yi-Long
authors.initials: YL
authors.lastname: Wu
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors