title: Survival of T4aN0 and T3N+ laryngeal cancer patients: a retrospective institutional study and systematic review.
abstract: OBJECTIVE
  We aim to assess the correlation of tumor and nodal staging to survival in pT3N+ and T4aN0 laryngeal cancer with subgroup analysis within stage IVa (pT4N0 and pT3N2).
  
  
  METHODS
  Retrospective cohort study with systematic review of the literature.
  
  
  METHODS
  Hotel Dieu de France University Hospital (tertiary referral center).
  
  
  METHODS
  Laryngeal cancer patients' registries were reviewed from 1998 to 2012 selecting pT3N+ and pT4aN0 patients treated by primary total layngectomy. Overall survivals were compared using Log rank and Kaplan-Meier analysis. A systematic review was performed by 2 reviewers including all the articles reporting the outcome of these categories of patients. Online databases, including PubMed and EMBASE, were used. Reference sections of identified studies were examined for additional articles.
  
  
  RESULTS
  Thirteen T3N+ patients and 19 T4aN0 patients treated by primary total laryngectomy were included. Five-year overall survival for T3N+, T3N2 and T4aN0 was respectively 33%, 32.1% and 73.7%. Due to the small sample, the difference was not significant. The systematic review revealed three articles reporting overall survival outcome for the T4N0 group and 6 articles for the T3N+. At 5years, the survival ranged from 62.5% to 73% in T4N0 and from 32.2% to 77% in T3N+.
  
  
  CONCLUSIONS
  In advanced stage laryngeal cancer, T4aN0 tends toward a better survival than T3N+ especially when compared to T3N2 although they are grouped in the same TNM stage IVa.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Hotel Dieu de France University Hospital, Saint Joseph University School of Medicine, Beirut, Lebanon.
authors.forename: Nadim
authors.initials: N
authors.lastname: Khoueir
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Hotel Dieu de France University Hospital, Saint Joseph University School of Medicine, Beirut, Lebanon.
authors.forename: Nayla
authors.initials: N
authors.lastname: Matar
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Hotel Dieu de France University Hospital, Saint Joseph University School of Medicine, Beirut, Lebanon. Electronic address: chadifarah86@hotmail.com.
authors.forename: Chadi
authors.initials: C
authors.lastname: Farah
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Hotel Dieu de France University Hospital, Saint Joseph University School of Medicine, Beirut, Lebanon.
authors.forename: Evana
authors.initials: E
authors.lastname: Francis
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Hotel Dieu de France University Hospital, Saint Joseph University School of Medicine, Beirut, Lebanon.
authors.forename: Bassam
authors.initials: B
authors.lastname: Tabchy
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Hotel Dieu de France University Hospital, Saint Joseph University School of Medicine, Beirut, Lebanon.
authors.forename: Amine
authors.initials: A
authors.lastname: Haddad
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D059248:Chemoradiotherapy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D007825:Laryngectomy; D007861:Lebanon / Q000453:epidemiology; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies