Treatment and predictive factors in patients with recurrent laryngeal carcinoma: A retrospective study

Abstract

The aim of the present retrospective analysis was to evaluate the treatment results for recurrent laryngeal cancer and to analyze the factors that may affect survival. A retrospective review was performed in 309 patients with recurrent laryngeal carcinoma, 224 of whom were treated between 1996 and 2009 at Sun Yat-Sen University Cancer Center (Guangzhou, Guangdong, China) and 85 of whom were treated between 2006 and 2013 at Zhejiang Cancer Hospital (Hangzhou, Zhejiang, China). The Kaplan-Meier method with the log-rank computation was used for the analysis of survival. The Cox proportional hazards model was applied to identify covariates that were significantly associated with overall survival. The actuarial 3-, 5- and 10-year survival rates were 68.9, 53.6 and 35.7%, respectively. Univariate analysis indicated that the following factors were associated with survival: Age, smoking index, tumor grade, primary tumor site, nodal status of the primary tumor, initial T stage, initial Union for International Cancer Control stage, initial treatment (radiotherapy or chemotherapy), disease-free interval, eligibility for surgery and extent of recurrence. Multivariate analysis of these factors indicated that the initial T stage, tumor grade, nodal status, disease-free interval and eligibility for surgery were significantly associated with survival. Overall, these results indicate that initial tumor stage T1 or T2, a high differentiation rate, no initial cervical lymph node metastasis, a long disease-free interval and a strong indication for salvage surgery are good prognostic factors for the survival of patients with recurrent laryngeal carcinoma.