title: Surgery-based versus radiation-based treatment strategy for a high metabolic volume laryngeal cancer.
abstract: We previously reported that the metabolic tumor volume (MTV) of a primary tumor was an independent prognostic factor for survival in laryngeal carcinoma treated by radiotherapy (RT)-based protocol. The purpose of this study was to evaluate the difference in survival outcomes between surgery-based and RT-based treatment in patients with a MTV laryngeal cancer.
  
  
  
  An individual retrospective cohort study.
  
  
  
  We reviewed the records of 63 patients with laryngeal cancer showing a primary tumor with a high MTV value (≥ 4.9 mL). The patients were separated into two groups by primary treatment strategy: 22 patients were included in the surgery group, and 41 patients were included in the RT group. Clinical factors and treatment modalities were analyzed for their association with survival.
  
  
  
  Multivariate analysis, including age, sex, subsite, T classification, nodal metastasis, and treatment modality, showed that the subsite (hazard ratio [HR] 2.55, P = 0.043) and treatment modality (HR 3.98, P = 0.019) were independent predictors for survival. The Kaplan-Meier curves for 2-year relapse-free survival rates and overall survival rates for patients in the surgery and RT groups were 74.2% versus 38.8% (P = 0.025) and 80.1% versus 66.7% (P = 0.078).
  
  
  
  Patients with a high metabolic volume laryngeal cancer treated by a surgery-based protocol showed better relapse-free survival and overall survival than did those undergoing RT-based treatment. Pretreatment MTV assessment could be useful in planning the treatment strategy for patients with a laryngeal cancer.
  
  
  
  2b. Laryngoscope, 127:862-867, 2017.
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
authors: Kenichiro
authors: 0000-0002-5099-1901
authors: K
authors: Yabuki
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
authors: Daisuke
authors: D
authors: Sano
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
authors: Osamu
authors: O
authors: Shiono
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
authors: Yasuhiro
authors: Y
authors: Arai
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
authors: Yoshihiro
authors: Y
authors: Chiba
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
authors: Teruhiko
authors: T
authors: Tanabe
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
authors: Goshi
authors: G
authors: Nishimura
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
authors: Masahiro
authors: M
authors: Takahashi
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
authors: Takahide
authors: T
authors: Taguchi
authors: Department of Radiology, Yokohama City University School of Medicine, Yokohama, Japan.
authors: Tomohiro
authors: T
authors: Kaneta
authors: Department of Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors: Masaharu
authors: M
authors: Hata
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
authors: Nobuhiko
authors: N
authors: Oridate
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome; D047368:Tumor Burden / Q000187:drug effects / Q000528:radiation effects
keywords: Laryngeal cancer; metabolic tumor volume; radiotherapy; surgery; survival