Multivariate analysis of prognostic factors in T3 N0 laryngeal carcinoma treated with total laryngectomy

OBJECTIVE: The aim of our study was to clarify the real importance of 16 possible prognostic factors analyzed retrospectively for the disease-free interval and survival of a total of 327 patients with T3 N0 M0 laryngeal carcinoma treated with total laryngectomy. METHODS: The role of each possible prognostic factor and their joint effect was explored by Cox proportional hazard survival analysis. RESULTS and CONCLUSIONS: In a Cox univariate analysis for the whole group, tumor site, pattern of growth, tumor size, histologic grading, lymph node status, and the occurrence of postoperative complications were predictive of the risk of tumor recurrence. In univariate analysis, all these factors except for pattern of tumor growth, neck treatment and postoperative complications maintained their prognostic value when analyzed as predictors of survival; however, the loco-regional control of disease was the most significant one. In a Cox multivariate analysis tumor size, histologic grading and postoperative complications had a significant impact on disease-free survival, whereas only histologic grading and loco-regional failure apeared to be prognostic with a significant decrease in overall survival. Copyright © 2003 by the American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc.