Laryngeal carcinoma--multivariate analysis of prognostic factors in 1252 consecutive patients treated with primary radiotherapy.

Multivariate analyses of prognostic factors were carried out in 1252 consecutive patients with laryngeal squamous cell carcinoma treated with primary radical radiotherapy. Ten percent of patients had positive neck nodes Most of the patients were in stage I (48%), the remainder in stage II (24%), III (18%) and IV (10%). Of these patients, 746/1 252 (60%) were controlled by primary treatment but 506/1 252 (40%) had residual tumor or recurrent disease. The larynx was preserved in 62% of patients. The 5-year actuarial values for disease-specific and overall survival were 78% and 60%, respectively. The results of a univariate analysis showed multiple significant prognostic factors, and in a Cox proportional hazards model it was found that gender and T-classification were significant for T-failure, locoregional failure, death from cancer and death from all causes. The region of origin, nodal involvement, differentiation and pretreatment hemoglobin value were significant for several of the above-mentioned endpoints. Laryngeal carcinoma is curable when treated with primary radiotherapy, and this treatment confers a high degree of organ preservation. Independent prognostic factors in the multivariate analyses were gender, region of origin, T-stage, nodal involvement, differentiation and hemoglobin.