title: Prognostic implications of pathologically determined tumour volume in glottic carcinomas treated by transoral laser microsurgery.
abstract: OBJECTIVE
  The TNM classification system for squamous cell carcinoma (SCC) of the head and neck neglects to incorporate volumetric analysis of the primary tumour. Tumour volume (TV) has been implicated prognostically in laryngeal SCC treated by primary radiotherapy (RT), but data for patients treated surgically are lacking. We evaluated such for glottic SCCs resected by transoral laser microsurgery (TLM).
  
  
  METHODS
  Retrospective cohort study utilising TVs calculated as the product of tumour resection dimensions and time-to-event analyses using the Kaplan-Meier method. The prognostic ability of variables was estimated using log-rank statistics, univariate Cox regression and receiver-operating characteristics analysis where appropriate.
  
  
  METHODS
  Tertiary referral head and neck cancer centre.
  
  
  METHODS
  Patients undergoing primary TLM for glottic SCC with curative intent (2007-2011) with at least 12 months follow-up data.
  
  
  METHODS
  Prognostic impact of TV on local control (LC), overall survival (OS) and disease-specific survival (DSS).
  
  
  RESULTS
  Eligible patients (n = 129) had a median follow-up of 40 months (range 14-79 months). Median TV for all cases was 300 mm(3) (range 2-19800 mm(3)). Three-year LC, OS and DSS were 92%, 92% and 98%, respectively. Tumour volume was not a significant predictor of any oncological outcome measure. Otherwise, a significant influence of pT stage on DSS was observed and of age on OS.
  
  
  CONCLUSIONS
  In contrast to laryngeal SCC treated by RT, TV does not appear to portend oncological outcome in glottic SCC managed specifically by TLM and consequently does not warrant incorporation into current prognostic models for such patients.
authors: Department of Otorhinolaryngology - Head & Neck Surgery, University Hospital Aintree, Liverpool, UK.|Liverpool Cancer Research Centre, Department of Molecular & Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
authors: M D
authors: MD
authors: Wilkie
authors: Department of Otorhinolaryngology - Head & Neck Surgery, University Hospital Aintree, Liverpool, UK.
authors: K A
authors: KA
authors: Lightbody
authors: School of Medicine, University of Liverpool, Liverpool, UK.
authors: R
authors: R
authors: Pinto
authors: Department of Otorhinolaryngology - Head & Neck Surgery, University Hospital Aintree, Liverpool, UK.
authors: S
authors: S
authors: Tandon
authors: Department of Otorhinolaryngology - Head & Neck Surgery, University Hospital Aintree, Liverpool, UK.|Liverpool Cancer Research Centre, Department of Molecular & Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
authors: T M
authors: TM
authors: Jones
authors: Department of Otorhinolaryngology - Head & Neck Surgery, University Hospital Aintree, Liverpool, UK.
authors: J
authors: J
authors: Lancaster
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D006113:United Kingdom / Q000453:epidemiology