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- Title
Surgery-based versus radiation-based treatment strategy for a high metabolic volume laryngeal cancer.
- Authors
Yabuki, Kenichiro; Sano, Daisuke; Shiono, Osamu; Arai, Yasuhiro; Chiba, Yoshihiro; Tanabe, Teruhiko; Nishimura, Goshi; Takahashi, Masahiro; Taguchi, Takahide; Kaneta, Tomohiro; Hata, Masaharu; Oridate, Nobuhiko
- Abstract
<bold>Objective/hypothesis: </bold>We previously reported that the metabolic tumor volume (MTV) of a primary tumor was an independent prognostic factor for survival in laryngeal carcinoma treated by radiotherapy (RT)-based protocol. The purpose of this study was to evaluate the difference in survival outcomes between surgery-based and RT-based treatment in patients with a MTV laryngeal cancer.<bold>Study Design: </bold>An individual retrospective cohort study.<bold>Methods: </bold>We reviewed the records of 63 patients with laryngeal cancer showing a primary tumor with a high MTV value (≥ 4.9 mL). The patients were separated into two groups by primary treatment strategy: 22 patients were included in the surgery group, and 41 patients were included in the RT group. Clinical factors and treatment modalities were analyzed for their association with survival.<bold>Results: </bold>Multivariate analysis, including age, sex, subsite, T classification, nodal metastasis, and treatment modality, showed that the subsite (hazard ratio [HR] 2.55, P = 0.043) and treatment modality (HR 3.98, P = 0.019) were independent predictors for survival. The Kaplan-Meier curves for 2-year relapse-free survival rates and overall survival rates for patients in the surgery and RT groups were 74.2% versus 38.8% (P = 0.025) and 80.1% versus 66.7% (P = 0.078).<bold>Conclusions: </bold>Patients with a high metabolic volume laryngeal cancer treated by a surgery-based protocol showed better relapse-free survival and overall survival than did those undergoing RT-based treatment. Pretreatment MTV assessment could be useful in planning the treatment strategy for patients with a laryngeal cancer.<bold>Level Of Evidence: </bold>2b. Laryngoscope, 127:862-867, 2017.
- Subjects
ONCOLOGY; THERAPEUTICS; MEDICAL technology; RADIOBIOLOGY; INCURABLE diseases; ANTHROPOMETRY; CANCER invasiveness; COMBINED modality therapy; COMPARATIVE studies; LARYNGECTOMY; LARYNGEAL tumors; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MULTIVARIATE analysis; NONPARAMETRIC statistics; PROGNOSIS; RADIOTHERAPY; RESEARCH; RISK assessment; SQUAMOUS cell carcinoma; SURVIVAL analysis (Biometry); POSITRON emission tomography; TUMOR classification; EVALUATION research; TREATMENT effectiveness; PROPORTIONAL hazards models; RETROSPECTIVE studies; KAPLAN-Meier estimator
- Publication
Laryngoscope, 2017, Vol 127, Issue 4, p862
- ISSN
0023-852X
- Publication type
journal article
- DOI
10.1002/lary.26233