Tumor volume as a predictor of survival in T3 glottic carcinoma: A novel approach to patient selection

Dziegielewski, Peter T.; Reschly, William J.; Morris, C.G.; DeJesus, Reordan; Silver, Natalie L.; Boyce, Brian; Santiago, I.; Amdur, Robert J.; Mendenhall, William M.

doi:10.1016/j.oraloncology.2018.02.015

Cited by 20 publications

(35 citation statements)

References 33 publications

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“…We chose to calculate TV using a validated method of calculating the ellipsoid volume based on maximum orthogonal diameters in three planes. This is in contrast to the methods used in other series, in which the tumor was outlined slice‐by‐slice and a computer algorithm calculated the total volume 34‐39 . The computerized method is dependent on the presence of digitalized data and is therefore logistically challenging if only hardcopy films are available, as was the case in some of our earlier cases.…”

Section: Discussionmentioning

confidence: 90%

Primary tumor volume as a predictor of distant metastases and survival in patients with sinonasal mucosal melanoma

et al. 2020

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Background: Sinonasal mucosal melanoma (SNMM) is an aggressive cancer with high mortality. Identifying patients at risk of distant metastasis assists with management and prognostication. We aimed to define the relationship between volume, survival, and risk of distant metastases. Methods: A retrospective review of all patients with SNMM treated at a single institution over a 21-year period was conducted. Tumor volume was calculated using cross-sectional imaging and survival analysis was performed. Results: Sixty-one patients were included. Tumor volume was predictive of local progression-free survival (P = .03), distant metastases-free survival (DMFS) (P = .002), and overall survival (OS) (P = .02). It was a better predictor than AJCC stage and T-classification. Tumor volume equal to or greater than 5 cm 3 was associated with a significantly worse DMFS and OS (P = .02 and .009, respectively). Conclusion: Calculation of tumor volume assists in quantifying the risk of distant metastases and death in SNMM.

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Section: Discussionmentioning

confidence: 90%

Primary tumor volume as a predictor of distant metastases and survival in patients with sinonasal mucosal melanoma

et al. 2020

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“…Patients who are suitable for chemoRT are those with unilateral cord involvement, low volume (3.5 cc or less calculated diagnostic contrast enhanced computed tomography), and a good airway. 52 Patients with more advanced T3-T4 SCCs are best treated with TL and neck dissection followed by postoperative RT/chemoRT. 2 However, those without destruction of cartilage framework, significant base of tongue involvement, and no baseline laryngeal dysfunction can also be candidates for organ preservation treatment provided that the tumor shrinks significantly and/or mobility of the larynx restores after a few cycles of induction chemotherapy, confirming its sensitivity to chemotherapeutics and also RT.…”

Section: T3-tsccmentioning

confidence: 99%

“…Prophylactic extraction of healthy teeth prior to RT does not reduce the risk of osteoradionecrosis (ORN) and is not recommended. 52,60 This is usually not an issue for patients with laryngeal cancer because the oral cavity is usually not irradiated.…”

Section: T3-tsccmentioning

confidence: 99%

“…Although some patients with low volume tumors may be suitable for a partial laryngectomy, these patients are also good candidates for chemoRT and, because some patients undergoing a partial laryngectomy would likely require postoperative RT, the functional outcome after successful chemoRT would probably be better. Patients who are suitable for chemoRT are those with unilateral cord involvement, low volume (3.5 cc or less calculated diagnostic contrast enhanced computed tomography), and a good airway 52 . Patients with more advanced T3‐T4 SCCs are best treated with TL and neck dissection followed by postoperative RT/chemoRT 2 .…”

Section: T3‐t4 Sccmentioning

confidence: 99%

“…Dentulous patients are evaluated by a dentist prior to initiating RT; teeth that are likely to require future extraction are removed and fluoride trays are fashioned for use with fluoride gel following RT to reduce the risk of dental caries. Prophylactic extraction of healthy teeth prior to RT does not reduce the risk of osteoradionecrosis (ORN) and is not recommended 52,60 . This is usually not an issue for patients with laryngeal cancer because the oral cavity is usually not irradiated.…”

Section: T3‐t4 Sccmentioning

confidence: 99%

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Radiotherapy in the management of glottic squamous cell carcinoma

et al. 2020

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Introduction: Our purpose is to review the role radiotherapy (RT) in the treatment of glottic squamous cell carcinoma (SCC). Methods: A concise review of the pertinent literature. Results: RT cure rates are Tis-T1N0, 90% to 95%; T2N0, 70% to 80%; lowvolume T3-T4a, 65% to 70%. Concomitant cisplatin is given for T3-T4a SCCs. Severe complications occur in 1% to 2% for Tis-T2N0 and 10% for T3-T4a SCCs. Patients with high-volume T3-T4 SCCs undergo total laryngectomy, neck dissection, and postoperative RT. Those with positive margins and/or extranodal extension receive concomitant cisplatin. The likelihood of local-regional control at 5 years is 85% to 90%. Severe complications occur in 5% to 10%. Conclusions: RT is a good treatment option for patients with Tis-T2N0 and low-volume T3-T4a glottic SCCs. Patients with higher volume T3-T4 cancers are best treated with surgery and postoperative RT.

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Association of Primary Tumor Volume With Survival in Patients With T3 Glottic Cancer Treated With Radiotherapy

Malik

Hainc

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceThe association of primary tumor volume with outcomes in T3 glottic cancers treated with radiotherapy with concurrent chemotherapy remains unclear, with some evidence suggesting worse locoregional control in larger tumors.ObjectiveTo evaluate the association of primary tumor volume with oncologic outcomes in patients with T3 N0-N3 M0 glottic cancer treated with primary (chemo)radiotherapy in a large multi-institutional study.Design, Setting, and ParticipantsThis multi-institutional retrospective cohort study involved 7 Canadian cancer centers from 2002 to 2018. Tumor volume was measured by expert neuroradiologists on diagnostic imaging. Clinical and outcome data were extracted from electronic medical records. Overall survival (OS) and disease-free survival (DFS) outcomes were assessed with marginal Cox regression. Laryngectomy-free survival (LFS) was modeled as a secondary analysis. Patients diagnosed with cT3 N0-N3 M0 glottic cancers from 2002 to 2018 and treated with curative intent intensity-modulated radiotherapy (IMRT) with or without chemotherapy. Overall, 319 patients met study inclusion criteria.ExposuresTumor volume as measured on diagnostic imaging by expert neuroradiologists.Main Outcomes and MeasuresPrimary outcomes were OS and DFS; LFS was assessed as a secondary analysis, and late toxic effects as an exploratory analysis determined before start of the study.ResultsThe mean (SD) age of participants was 66 (12) years and 279 (88%) were men. Overall, 268 patients (84%) had N0 disease, and 150 (47%) received concurrent systemic therapy. The mean (SD) tumor volume was 4.04 (3.92) cm3. With a mean (SD) follow-up of 3.85 (3.04) years, there were 91 (29%) local, 35 (11%) regional, and 38 (12%) distant failures. Increasing tumor volume (per 1-cm3 increase) was associated with significantly worse adjusted OS (hazard ratio [HR], 1.07; 95% CI, 1.03-1.11) and DFS (HR, 1.04; 95% CI, 1.01-1.07). A total of 62 patients (19%) underwent laryngectomies with 54 (87%) of these within 800 days after treatment. Concurrent systemic therapy was associated with improved LFS (subdistribution HR, 0.63; 95% CI, 0.53-0.76).Conclusions and RelevanceIncreasing tumor volumes in cT3 glottic cancers was associated with worse OS and DFS, and systemic therapy was associated with improved LFS. In absence of randomized clinical trial evidence, patients with poor pretreatment laryngeal function or those ineligible for systemic therapy may be considered for primary surgical resection with postoperative radiotherapy.

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Tumor volume as a predictor of survival in T3 glottic carcinoma: A novel approach to patient selection

Cited by 20 publications

References 33 publications

Primary tumor volume as a predictor of distant metastases and survival in patients with sinonasal mucosal melanoma

Primary tumor volume as a predictor of distant metastases and survival in patients with sinonasal mucosal melanoma

Radiotherapy in the management of glottic squamous cell carcinoma

Association of Primary Tumor Volume With Survival in Patients With T3 Glottic Cancer Treated With Radiotherapy

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