Jay C Shiao1,2, Abdallah S R Mohamed1,3, Jay A Messer1,4, Katherine A Hutcheson5, Jason M Johnson6, Heiko Enderling7, Mona Kamal1,8, Benjamin W Warren1, Brian Pham1, William H Morrison1, Mark E Zafereo5, Amy C Hessel5, Stephen Y Lai5, Merril S Kies9, Renata Ferrarotto9, Adam S Garden1, Donald F Schomer6, G Brandon Gunn1, Jack Phan1, Steven J Frank1, Beth M Beadle1, Randal S Weber5, Jan S Lewin5, David I Rosenthal1, Clifton D Fuller1,10. 1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 2. School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas. 3. Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt. 4. Department of Radiation Oncology, The University of Texas Medical Branch, Galveston, Texas. 5. Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas. 6. Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 7. Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. 8. Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Ain Shams, Cairo, Egypt. 9. Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 10. Medical Physics Program, The University of Texas Graduate School of Biomedical Sciences, Houston, Texas.
Abstract
BACKGROUND: The purpose of this study was to determine the impact of CT-determined pretreatment primary tumor volume on survival and disease control in T4a laryngeal squamous cell carcinoma (SCC). METHODS: We retrospectively reviewed 124 patients with T4a laryngeal cancer from 2000-2011. Tumor volume measurements were collected and correlated with outcomes. RESULTS: Five-year overall survival (OS) for patients with tumor volume ≥21 cm3 treated with larynx preservation (n = 26 of 41) was significantly inferior compared to <21 cm3 (42% vs 64%, respectively; P = .003). Five-year OS for patients with tumor volumes ≥21 cm3 in the cohort treated with total laryngectomy followed by radiotherapy (RT; n = 42 of 83) was not statistically significant when compared to <21 cm3 (50% vs 63%, respectively; P = .058). On multivariate analysis, tumor volume ≥21 cm3 was a significant independent correlate of worse disease-specific survival (DSS; P = .004), event-free survival (P = .005), recurrence-free survival (RFS; P = .04), noncancer cause-specific survival (P = .02), and OS (P = .0002). CONCLUSION: Pretreatment CT-based tumor volume is an independent prognostic factor of outcomes in T4a laryngeal cancer.
BACKGROUND: The purpose of this study was to determine the impact of CT-determined pretreatment primary tumor volume on survival and disease control in T4a laryngeal squamous cell carcinoma (SCC). METHODS: We retrospectively reviewed 124 patients with T4a laryngeal cancer from 2000-2011. Tumor volume measurements were collected and correlated with outcomes. RESULTS: Five-year overall survival (OS) for patients with tumor volume ≥21 cm3 treated with larynx preservation (n = 26 of 41) was significantly inferior compared to <21 cm3 (42% vs 64%, respectively; P = .003). Five-year OS for patients with tumor volumes ≥21 cm3 in the cohort treated with total laryngectomy followed by radiotherapy (RT; n = 42 of 83) was not statistically significant when compared to <21 cm3 (50% vs 63%, respectively; P = .058). On multivariate analysis, tumor volume ≥21 cm3 was a significant independent correlate of worse disease-specific survival (DSS; P = .004), event-free survival (P = .005), recurrence-free survival (RFS; P = .04), noncancer cause-specific survival (P = .02), and OS (P = .0002). CONCLUSION: Pretreatment CT-based tumor volume is an independent prognostic factor of outcomes in T4a laryngeal cancer.
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