Liselotte W van Bockel1, Gerda M Verduijn2, Evelyn M Monninkhof3, Frank A Pameijer4, Chris H J Terhaard5. 1. University Medical Centre Utrecht, Department of Radiation Oncology, The Netherlands. Electronic address: l.w.vanbockel@umcutrecht.nl. 2. Erasmus Medical Centre, Department of Radiation Oncology, Rotterdam, The Netherlands. Electronic address: g.verduijn@erasmusmc.nl. 3. University Medical Centre Utrecht, Julius Center for Health Sciences and Primary Care, The Netherlands. Electronic address: e.monninkhof@umcutrecht.nl. 4. University Medical Centre Utrecht, Department of Radiology, The Netherlands. Electronic address: f.a.pameijer@umcutrecht.nl. 5. University Medical Centre Utrecht, Department of Radiation Oncology, The Netherlands. Electronic address: c.h.j.terhaard@umcutrecht.nl.
Abstract
BACKGROUND AND PURPOSE: Evaluation of the variation in tumor growth rate and the influence of tumor growth rate on disease free survival (DFS) and overall survival (OS) in laryngeal squamous cell carcinoma (LSCC). MATERIAL AND METHODS: We delineated tumor volume on a diagnostic and planning CT scan in 131 patients with laryngeal squamous cell carcinoma and calculated the tumor growth rate. Primary endpoint was DFS. Follow up data were collected retrospectively. RESULTS: A large variation in tumor growth rate was seen. When dichotomized with a cut-off point of -0.3 ln(cc/day), we found a significant association between high growth rate and worse DFS (p = 0.008) and OS (p = 0.013). After stepwise adjustment for potential confounders (age, differentiation and tumor volume) this significant association persisted. However, after adjustment of N-stage association disappeared. Exploratory analyses suggested a strong association between N-stage and tumor growth rate. CONCLUSIONS: In laryngeal squamous cell carcinoma, there is a large variation in tumor growth rate. This tumor growth rate seems to be an important factor in disease free survival and OS. This tumor growth rate is independent of age, differentiation and tumor volume associated with DFS, but N-stage seems to be a more important risk factor.
BACKGROUND AND PURPOSE: Evaluation of the variation in tumor growth rate and the influence of tumor growth rate on disease free survival (DFS) and overall survival (OS) in laryngeal squamous cell carcinoma (LSCC). MATERIAL AND METHODS: We delineated tumor volume on a diagnostic and planning CT scan in 131 patients with laryngeal squamous cell carcinoma and calculated the tumor growth rate. Primary endpoint was DFS. Follow up data were collected retrospectively. RESULTS: A large variation in tumor growth rate was seen. When dichotomized with a cut-off point of -0.3 ln(cc/day), we found a significant association between high growth rate and worse DFS (p = 0.008) and OS (p = 0.013). After stepwise adjustment for potential confounders (age, differentiation and tumor volume) this significant association persisted. However, after adjustment of N-stage association disappeared. Exploratory analyses suggested a strong association between N-stage and tumor growth rate. CONCLUSIONS: In laryngeal squamous cell carcinoma, there is a large variation in tumor growth rate. This tumor growth rate seems to be an important factor in disease free survival and OS. This tumor growth rate is independent of age, differentiation and tumor volume associated with DFS, but N-stage seems to be a more important risk factor.
Authors: Daniel Dejaco; Teresa Steinbichler; Volker Hans Schartinger; Natalie Fischer; Maria Anegg; Joszef Dudas; Andrea Posch; Gerlig Widmann; Herbert Riechelmann Journal: BMJ Open Date: 2019-02-19 Impact factor: 2.692