Predictive factors and treatment outcome of laryngeal carcinoma recurrence

Head Neck. 2017 Mar;39(3):555-563. doi: 10.1002/hed.24642. Epub 2016 Nov 30.

Abstract

Background: Up to 30% of patients with laryngeal squamous cell carcinoma (SCC) present with recurrence after treatment. We analyzed factors associated with the risk of cancer recurrence and prognosis after recurrence.

Methods: A nationwide laryngeal SCC cohort from Finnish university hospitals during 2001 to 2005 with initial successful therapy (n = 316) was analyzed.

Results: Laryngeal SCC recurred in 22% of patients. The median time to recurrence was 9 months, with 90% occurring within 36 months after treatment. The World Health Organization (WHO) performance status >0, neck metastasis at presentation, and nonsurgical treatment were independent prognostic factors for recurrence. Patients with local recurrence had a 5-year overall survival (OS) of 53% compared with 5% in patients with regional/distant recurrences. OS for glottic and nonglottic laryngeal SCC recurrence was 45% and 0%, respectively.

Conclusion: The type of treatment affected the risk of recurrence in this retrospective series. Local recurrences carried a chance for successful salvage treatment. Routine follow-up beyond 36 months remains controversial. © 2016 Wiley Periodicals, Inc. Head Neck 39: 555-563, 2017.

Keywords: laryngeal cancer; prognosis; radiotherapy; recurrence; surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy, Adjuvant / methods
  • Cohort Studies
  • Databases, Factual
  • Female
  • Finland
  • Hospitals, University
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / complications
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / therapy*
  • Laryngectomy / methods
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy*
  • Palliative Care*
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Salvage Therapy*
  • Sex Factors
  • Survival Analysis
  • Treatment Outcome