title: Tumor Volumes and Prognosis in Laryngeal Cancer.
abstract: Tumor staging systems for laryngeal cancer (LC) have been developed to assist in estimating prognosis after treatment and comparing treatment results across institutions. While the laryngeal TNM system has been shown to have prognostic information, varying cure rates in the literature have suggested concern about the accuracy and effectiveness of the T-classification in particular. To test the hypothesis that tumor volumes are more useful than T classification, we conducted a retrospective review of 78 patients with laryngeal cancer treated with radiation therapy at our institution. Using multivariable analysis, we demonstrate the significant prognostic value of anatomic volumes in patients with previously untreated laryngeal cancer. In this cohort, primary tumor volume (GTVP), composite nodal volumes (GTVN) and composite total volume (GTVP + GTVN = GTVC) had prognostic value in both univariate and multivariate cox model analysis. Interestingly, when anatomic volumes were measured from CT scans after a single cycle of induction chemotherapy, all significant prognosticating value for measured anatomic volumes was lost. Given the literature findings and the results of this study, the authors advocate the use of tumor anatomic volumes calculated from pretreatment scans to supplement the TNM staging system in subjects with untreated laryngeal cancer. The study found that tumor volume assessment after induction chemotherapy is not of prognostic significance.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, The University of Michigan Health System, 1903 Taubman Bldg, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. moeissa@med.umich.edu.
authors.forename: Mohamad R
authors.initials: MR
authors.lastname: Issa
authors.affiliation: Department of Radiation Oncology, The University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA. samuelss@med.umich.edu.
authors.forename: Stuart E
authors.initials: SE
authors.lastname: Samuels
authors.affiliation: Department of Biostatistics, The School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA. lighte@med.umich.edu.
authors.forename: Emily
authors.initials: E
authors.lastname: Bellile
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, The University of Michigan Health System, 1903 Taubman Bldg, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. fshalabi@umich.edu.
authors.forename: Firas L
authors.initials: FL
authors.lastname: Shalabi
authors.affiliation: Department of Radiation Oncology, The University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA. eisbruch@med.umich.edu.
authors.forename: Avraham
authors.initials: A
authors.lastname: Eisbruch
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, The University of Michigan Health System, 1903 Taubman Bldg, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. gregwolf@umich.edu.
authors.forename: Gregory
authors.initials: G
authors.lastname: Wolf
keywords: laryngeal cancer; prognosis; radiation therapy; tumor volume