Advanced Laryngeal Cancer: Relevance of Pathologic Stage to Survival and Therapy

Decker, John W.; Price, John C.; Goldstein, Jerome C.

doi:10.1001/archotol.1986.03780110039004

Cited by 16 publications

(2 citation statements)

References 30 publications

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“…In theory, all subgroups should be affected and in the same direction. This same phenomenon has been observed when the survival of patients with laryngeal carcinoma has been compared using clinical versus pathologic staging 43…”

Section: Discussionsupporting

confidence: 63%

The role of computed tomography in the T classification of laryngeal carcinoma

Barbera

Groome

Mackillop

et al. 2001

Cancer

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BACKGROUND The objectives of this study were 1) to describe patterns of use of computed tomography (CT) in laryngeal carcinoma, and 2) to characterize the contribution of CT to the T classification of laryngeal carcinoma. METHODS The study population comprised 1195 patients with laryngeal carcinoma diagnosed from 1982 through 1995 chosen randomly from the Ontario provincial cancer registry. A chart review was conducted to obtain data on each case. Patient‐related, tumor‐related, and health‐system‐related factors were analyzed to identify factors associated with the use of CT. Descriptions of clinical exams and CT reports were reviewed to see how CT information modified T classification. Actuarial local control and cause specific survival curves were plotted by clinical T classification without and with CT to evaluate stage migration. The percentage of the variance in outcome explained by T classification in a Cox analysis was used to evaluate whether the prognostic accuracy of T classification was improved with the use of information from CT. RESULTS Patients with glottic (20.1%) and supraglottic (41.7%) carcinoma underwent CT. The use of CT increased over time in glottic and supraglottic carcinoma combined from 17.2% in 1982–5 to 33.9% in 1991–5. Computed tomography was used less often in older patients with a 16% (95% confidence interval, 5– 27%) decrease in the odds of having CT with each 10‐year age increment. Computed tomography use varied considerably across the cancer center regions in Ontario. Computed tomography altered the T classification in 20.2% of those patients who had CT, with most being “upstages.” Stage migration due to CT was demonstrated. Using information from CT in the assignment of T classification for 27.8% of this study population did not make a significant contribution to the ability of T classification to predict outcome over the entire group. CONCLUSIONS There is large variation in the use of CT among different age groups and regions. The ability to compare outcomes by stage across geographic areas is compromised when the use of CT varies. Cancer 2001;91:394–407. © 2001 American Cancer Society.

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Section: Discussionsupporting

confidence: 63%

The role of computed tomography in the T classification of laryngeal carcinoma

Barbera

Groome

Mackillop

et al. 2001

Cancer

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“…No statistical significant difference was found with respect to T-stage comparing both classification systems. However, the larynx poses a problem for the clinical assessment of exact tumour extent (T-stage); it has even been suggested that newer generation CT-and/or MRI-scanners might prove valuable and could become even indispensible for assessing the accurate T category in the near future (18,(20)(21)(22)(23). Moreover, besides these limitations, only minor changes have been introduced with regard to T-stage in the recent UICC classification system (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Cancer of the Supraglottic Larynx with Neck Node Metastisis Treated by Radiation Therapy Only the revised 1987 UICC classification system as prognostic indicator

Levendag¹,

Veeze-Kuijpers²,

Knegt³

et al. 1990

Acta Oncologica

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Blood Transfusion and Other Risk Factors for Recurrence of Cancer of the Head and Neck

Jones

Weissler²

1990

Archives of Otolaryngology - Head and Neck Surgery

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To determine whether perioperative blood transfusion affected the recurrence rate of squamous cell cancer of the head and neck, we performed a retrospective study of all patients with stage III and IV disease treated surgically at the University of North Carolina, Chapel Hill, between 1983 and 1986. Those who recurred were compared with those who did not in regard to 16 prognostic variables, including whether or not they had received a perioperative blood transfusion. Analyzing each variable separately, five were significantly related to recurrence. These were (1) surgical margin status, (2) stage, (3) presence of pathologically positive nodes, (4) blood transfusion status, and (5) type of treatment. However, because several of these variables were clearly interrelated, the same data were subjected to a multivariate regression analysis specifically designed to identify significant prognostic variables independent of their association with other variables. By this analysis, only margin status and the presence or absence of a blood transfusion were statistically significant predictors of recurrence.

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Advanced Laryngeal Cancer: Relevance of Pathologic Stage to Survival and Therapy

Cited by 16 publications

References 30 publications

The role of computed tomography in the T classification of laryngeal carcinoma

The role of computed tomography in the T classification of laryngeal carcinoma

Cancer of the Supraglottic Larynx with Neck Node Metastisis Treated by Radiation Therapy Only the revised 1987 UICC classification system as prognostic indicator

Blood Transfusion and Other Risk Factors for Recurrence of Cancer of the Head and Neck

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