Quantitative pretreatment CT volumetry: Association with oncologic outcomes in patients with T4a squamous carcinoma of the larynx

Head Neck. 2017 Aug;39(8):1609-1620. doi: 10.1002/hed.24804. Epub 2017 May 2.

Abstract

Background: The purpose of this study was to determine the impact of CT-determined pretreatment primary tumor volume on survival and disease control in T4a laryngeal squamous cell carcinoma (SCC).

Methods: We retrospectively reviewed 124 patients with T4a laryngeal cancer from 2000-2011. Tumor volume measurements were collected and correlated with outcomes.

Results: Five-year overall survival (OS) for patients with tumor volume ≥21 cm3 treated with larynx preservation (n = 26 of 41) was significantly inferior compared to <21 cm3 (42% vs 64%, respectively; P = .003). Five-year OS for patients with tumor volumes ≥21 cm3 in the cohort treated with total laryngectomy followed by radiotherapy (RT; n = 42 of 83) was not statistically significant when compared to <21 cm3 (50% vs 63%, respectively; P = .058). On multivariate analysis, tumor volume ≥21 cm3 was a significant independent correlate of worse disease-specific survival (DSS; P = .004), event-free survival (P = .005), recurrence-free survival (RFS; P = .04), noncancer cause-specific survival (P = .02), and OS (P = .0002).

Conclusion: Pretreatment CT-based tumor volume is an independent prognostic factor of outcomes in T4a laryngeal cancer.

Keywords: T4a; outcomes; radiotherapy; survival; tumor; volume; volumetry.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / therapy
  • Combined Modality Therapy
  • Cone-Beam Computed Tomography
  • Female
  • Humans
  • Laryngeal Neoplasms / diagnostic imaging
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology*
  • Laryngeal Neoplasms / therapy
  • Laryngectomy
  • Larynx / diagnostic imaging
  • Larynx / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Radiotherapy
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Tumor Burden*