title: Prognostic value of total tumor volume in advanced-stage laryngeal and hypopharyngeal carcinoma.
abstract: BACKGROUND
  To evaluate the prognostic value of total tumor volume (TTV) in patients with laryngeal and hypopharyngeal carcinomas.
  
  
  METHODS
  This study involved 182 patients with previously untreated advanced-stage squamous cell carcinoma of the larynx or hypopharynx. TTV were calculated from pretreatment contrast-enhanced computed tomography images. Univariate and multivariate analyses were used to identify factors associated with overall (OS), disease-specific (DSS), and disease-free survival (DFS).
  
  
  RESULTS
  At a median follow-up of 63 months (range, 24-139 months), the 5 year OS, DSS, and DFS rates were 60.2%, 73.1%, and 69.4%, respectively. Multivariate analyses showed that tumor site was an independent predictor of DSS (P = 0.03); Charlson comorbidity index for OS (P = 0.001); second primary cancer for OS (P = 0.008) and DFS (P = 0.001); and vocal fold paralysis for DSS (P = 0.014) and DFS (P = 0.033). Extension to the tongue base was an independent predictor of OS (P = 0.007), DSS (P < 0.001), and DFS (P = 0.017), and TTV ≥8.38 ml was an independent predictor of all three survivals (P < 0.001 each).
  
  
  CONCLUSIONS
  Radiologically determined TTV is prognostic of survival in patients with advanced-stage laryngeal and hypopharyngeal carcinoma.
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Chan-Joo
authors.initials: CJ
authors.lastname: Yang
authors.forename: Dae-Yoon
authors.initials: DY
authors.lastname: Kim
authors.forename: Jeong Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Jong-Lyel
authors.initials: JL
authors.lastname: Roh
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Soon Yuhl
authors.initials: SY
authors.lastname: Nam
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D003287:Contrast Media; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D047368:Tumor Burden; D014826:Vocal Cord Paralysis / Q000209:etiology
chemical_list: D003287:Contrast Media
keywords: larynx, hypopharynx; squamous cell carcinoma; survival; total tumor volume