Prognosis in laryngeal carcinoma: tumour factors

Abstract

A personal series of 765 previously untreated patients with laryngeal carcinoma seen between 1962 and 1988 was analysed for the importance of prognostic factors. There were numerous significant correlations between tumour prognostic factors, particularly with neck node status. Palpable cervical nodes increased in frequency with increasing T status, and palpable lymph nodes were commoner in less well differentiated tumours, and in supra and sub-glottic tumours. These correlations were very highly significant. Increasing T stage was associated with increasing N stage. T stage was also associated with site, glottic tumours being far more likely to be T1 than supra or sub-glottic tumours. T stage was not related to histological grade. Histological grade correlated with site, glottic tumours being well differentiated much more often. When survival was analysed by univariate methods there were highly significant differences with increasing T stage and N stage, between the various histological grades and the various sites. However, when survival was analysed by multifactorial methods taking interactions into account, only N status was a significant prognostic factor. When patients with palpable nodes submitted to surgery were analysed, it transpired that clinical staging and node level were relatively unimportant compared with pathological findings: both the number of nodes invaded and the presence of tumour outside lymph nodes (extracapsular rupture) were highly significant.

Relationships Between Clinical Behavior of Laryngeal Squamous Cell Carcinomas and Expression of VEGF, MMP-9 and E-Cadherin

“…The clinical course of patients with laryngeal cancer diagnosis depends on parameters such as, age, gender, nutritional status and tumor characteristics (stage, localisation, histological pattern, nuclear grade). Well known prognostic factors are the increase in tumor size, lymph node metastasis, and the presence of capsular invasion (Stell, 1990).…”

Squamous carcinoma of the head and neck: cured fraction and median survival time as functions of age, sex, histologic type, and node status

“…For this analysis, surgery was coded as 2 if definitive resection was attempted and as 1 (Norris, 1963). Stell noted that neck node status completely overshadows other prognostic factors in laryngeal carcinoma and that patients with nodal involvement were likely to have high T stage and poorly differentiated tumours (Stell, 1990b As can be seen in Table V, histologic type and age are also important predictors for SCHN. Unlike nodal status, however, these two covariates are asymmetric predictors-histologic type is significantly associated only with cured fraction, while age is significantly associated only with median survival time.…”

Tumour-Associated Tissue Eosinophilia in Head and Neck Squamous-Cell Carcinoma

“…The classical staging of the primary tumour and its degree of regional spread based upon the TNM classification offer only a prognostic tool as far as the N stage is concerned [1,2].…”