Prognostic impact of different tumor invasion patterns in the surgical treatment of T3 glottic laryngeal cancer

LING Zhiming; HU Guohua; WANG Zhihai; MA Wei; WANG Xiaoqiang; ZHU Jiang; ZENG Quan

doi:10.13201/j.issn.2096-7993.2023.12.015

Article navigation > J Clin Otorhinolaryngol Head Neck Surg > 2023 > 37(12): 998-1004

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LING Zhiming, HU Guohua, WANG Zhihai, et al. Prognostic impact of different tumor invasion patterns in the surgical treatment of T3 glottic laryngeal cancer[J]. J Clin Otorhinolaryngol Head Neck Surg, 2023, 37(12): 998-1004. doi: 10.13201/j.issn.2096-7993.2023.12.015

Citation:

Prognostic impact of different tumor invasion patterns in the surgical treatment of T3 glottic laryngeal cancer

Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China

More Information

Corresponding author: ZENG Quan, E-mail: z1q0318@163.com

Received Date: 30 May 2023

Publish Date: 03 December 2023

Abstract

Abstract

Objective
To investigate the prognostic impact of different tumor invasion patterns in the surgical treatment of T3 glottic laryngeal cancer.
Methods
A retrospective analysis was conducted on the clinical data of 91 patients with T3 glottic laryngeal cancer.
Results
Among the 91 patients, 58 cases (63.7%) had anterior invasion and 33 cases (36.3%) had posterior invasion. The posterior invasion was significantly correlated with invasions of the dorsal plate of cricoid cartilage (P < 0.001), arytenoid cartilage (P= 0.001), and subglottic region(P = 0.001). There was no statistical difference in survival outcomes between the total laryngectomy group and the partial laryngectomy group. But in the partial laryngectomy group, the 5-year disease-free survival(DFS) of patients with anterior invasive tumors was better than that of patients with posterior invasion tumors (HR: 4.681, 95%CI 1.337-16.393, P=0.016), and subglottic invasion was associated with worse loco-regional recurrence-free survival(LRRFS)(HR: 3.931, 95%CI 1.054-14.658, P=0.041). At the same time, we found that involvement of the dorsal plate of cricoid cartilage was an independent risk factor for postoperative laryngeal stenosis in partial laryngectomy patients (HR: 11.67, 95%CI 1.89-71.98, P=0.008).
Conclusion
Compared with total laryngectomy, selected partial laryngectomy can also achieve favorable oncological outcomes. Posterior invasion and subglottic extension are independent prognostic factors for recurrence of partial laryngectomy in T3 glottic laryngeal cancer, and the involvement of the dorsal plate of cricoid cartilage is associated with postoperative laryngeal stenosis. The tumor invasion pattern of laryngeal cancer should be further subdivided in order to select a more individualized treatment plan.
- laryngeal neoplasms /
- neoplasm invasion /
- laryngectomy /
- prognosis

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References

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