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Article
January 1996

Prognostic Factors in T3,N0-1 Glottic and Transglottic Carcinoma: A Multifactorial Study of 221 Cases Treated by Surgery or Radiotherapy

Arch Otolaryngol Head Neck Surg. 1996;122(1):77-82. doi:10.1001/archotol.1996.01890130069011
Abstract

Objective:  To evaluate prognostic factors in patients with T3,N0-1 glottic and transglottic carcinoma treated in a single institution.

Design:  Retrospective, nonrandomized case series.

Setting:  Tertiary case referral centers, ambulatory or hospitalized care.

Patients:  Two hundred twenty-one consecutive cases of stage III glottic or transglottic squamous cell carcinoma. Tumor stage was T3,N0,M0 in 167 cases and T3,N1,M0 in 54 cases.

Interventions:  Surgery in 176 cases and radiotherapy in 45 cases.

Main Outcome Measures:  Recurrences and survival (multivariate).

Results:  Almost 7% of the patients who underwent surgery and 39.6% who had radiotherapy had local recurrences. Recurrences in the neck were seen in 16.4% of the patients who underwent surgery and in 10.5% of those who had radiotherapy. Distant metastases were diagnosed only in patients who underwent surgery (4.6%). The 5-year actuarial overall survival rates were 56.3% in the surgical group and 35.2% in the radiotherapy group (P=.007). Age involvement of pyriform sinus, N stage, and history of tracheostomy were independent prognostic factors for risk of death.

Conclusions:  The presence of metastatic lymph nodes, age, and involvement of the pyriform sinus were the important prognostic factors in patients who underwent surgery. A small group of patients with T3,N0,M0 tumors could benefit from radiotherapy, with surgery reserved for recurrence.(Arch Otolaryngol Head Neck Surg. 1996;122:77-82)

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