Treatment package time predicts cancer‑specific survival and distant metastasis in laryngeal cancer

Abstract

We investigated whether treatment package time was significantly associated with survival outcomes of resectable locally-advanced laryngeal squamous cell carcinoma in patients who consecutively underwent various treatments, including surgery alone and salvage surgery for residual tumor. A total of 100 patients with clinical T3-T4 resectable laryngeal squamous cell carcinoma were enrolled in this study. The treatment package time was calculated in days between the start of any treatment and the end of all treatments, including postoperative radiotherapy and salvage surgery for residual tumors. Using a log-rank test, a treatment package time of ≥68 days showed significantly shorter cancer-specific (P= 0.0013) and distant metastasis-free survival (P= 0.0017), compared with a treatment package time of <68 days. Multivariate survival analyses of two Cox's hazards proportional models was conducted. In both model-1, which adjusted for cT3/cT4, cN0-1/cN2-3 and total laryngectomy/non-total laryngectomy, and model-2, which adjusted for cT3/cT4, cN0-1/cN2-3 and induction therapy/non-induction therapy, the cancer-specific survival and distant metastasis-free survival, according to treatment package time, were significantly longer with <68 days compared with ≥68 days (P<0.01). The present study demonstrated that a prolonged treatment package time is a prognostic factor for shorter cancer-specific and distant metastasis-free survival after various treatments for resectable locally-advanced laryngeal cancer.

Missed radiation therapy sessions in first three weeks predict distant metastasis and less favorable outcomes in surgically treated patients with oral cavity squamous cell carcinoma

“…An RTT > 8 weeks was found to predict poor OS rates and a higher risk of local and distant recurrences [ 29 ] in different solid neoplasms [ 7 , 12 , 30 ]. Another report identified a prolonged TPT as an adverse predictor of cancer-specific survival and FFDM in patients with locally advanced laryngeal cancer [ 31 ].…”

Association between treatment package time and clinical predictors in oropharyngeal cancer

“…The selection of initial treatment and the regimens of induction chemotherapy, RT or CRT, and salvage surgery for the residual tumor have been reported elsewhere. [ 6 ] In short, patients who refused to undergo operation selected CRT or RT, and those who hoped for maximal organ preservation without reducing treatment efficacy selected chemoselection. In the chemotherapy regimen, 5-fluorouracil and cisplatin for induction chemotherapy or a platinum for CRT were mainly used.…”

“…[ 1 – 5 ] We previously reported several outcome predictors, such as 18F-fluorodeoxyglucose (18F-FDG) uptake, smoking status, and synchronous cancer of head and neck cancer, including OPSCC. [ 2 – 4 , 6 , 7 ] Alcohol consumption and smoking were evaluated as life factors. [ 12 ] Sake and Brinkman indices were used as methods to evaluate alcohol consumption and smoking, respectively.…”

“…Prolonged treatment package time (TPT), which is defined as the duration from the start of any treatment to the completion of all treatments, [ 6 , 8 ] has been shown to predict worse survival outcomes in head and neck cancer. [ 6 , 8 – 10 ] We also reported a significant association between TPT and the survival outcomes of laryngeal cancer in patients who consecutively underwent various treatments, including salvage surgery for residual tumor. [ 6 ] However, the association between TPT and clinical predictors such as 18F-FDG uptake in OPSCC is not fully investigated.…”

“…[ 6 , 8 – 10 ] We also reported a significant association between TPT and the survival outcomes of laryngeal cancer in patients who consecutively underwent various treatments, including salvage surgery for residual tumor. [ 6 ] However, the association between TPT and clinical predictors such as 18F-FDG uptake in OPSCC is not fully investigated. Therefore, we aimed to investigate the association of TPT with survival outcomes and clinical parameters, including 18F-FDG uptake, in patients with OPSCC.…”