Wznowy u pacjentów leczonych operacyjnie z powodu raka krtani
Journal Title: Otolaryngologia Polska - Year 2009, Vol 63, Issue 5
Abstract
Purpose: The aim of the present study was to investigate the recurrence prevalence in patients with laryngeal squamous cell carcinoma (LSCC) underwent surgery as primary treatment. Material: The assessed group consisted of 148 patients with operable LSCC underwent surgery as primary treatment between 1999-2002. Surgery was performed in all cases. Total laryngectomy was performed in 107 (72.3%) patients and laser endoscopic tumor resection was performed in 41 (27.7%) patients. Results: Local recurrence occurred in 18 (12.2%) patients, nodal recurrence in 12 (8.1%) and both and/or remote metastases in 6 (4%) patients. Altogether, recurrence was present in 36 (24.3%) patients and 111 (75.7%) patients had no symptoms of recurrence. Recurrence prevalence in 3-year follow-up - prevalence of recurrence signifi cantly increased with tumor’s T feature (p=0.04), N feature (p=0.03), progression of clinical stage (p=0.008) and histological malignancy G stage (p=0.01). Recurrence prevalence in 5-year follow-up – prevalence of recurrence signifi cantly increased with tumor’s T feature (p=0.02), N feature (p=0.01), progression of clinical stage (p=0.003) and histological malignancy G stage (p=0.002). Tumors localized in glottic area had less recurrences than those localized in supraglottic area (p=0.05). There were no signifi cant dependence between recurrence type (local or nodal) and tumor’s clinicopathological features. Multiple factor analysis with logistic regression model did not revealed simultaneous infl uence of many variables on recurrence’s presence and type. Using multiple factor analysis with Cox’s regression model it was proved that recurrence presence (p< 0.00001) is a signifi cant independent prognostic factor in the analyzed group of patients with laryngeal carcinoma in 3-year follow-up. Conclusions: Recurrence prevalence depends on localization, systemic progression stage, clinical progression stage, cervical lymph nodes state and histological malignancy stage of tumor. Patients with local recurrence have statistically signifi cantly worse prognosis than patients with no recurrence. Recurrence presence is signifi cant independent prognostic factor in 3-year follow-up.
Authors and Affiliations
Kamal Morshed, Marcin Szymański, Marek Zadrożniak, Henryk Siwiec, Agnieszka Wawrzecka, Rashad Abushammalah, Agata Smoleń
Keywords
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