Recurrent laryngeal squamous cell carcinoma: rTNM versus composite laryngeal recurrence staging system. Proposal for a modification of the CLRSS to improve patient classification.

Abstract

Based on the initial TNM stage of the tumor and the extension of recurrence, the composite laryngeal recurrence staging system (CLRSS) has been proposed as an alternative to the rTNM system for staging patients with recurrent laryngeal carcinoma. The objective of our study was to carry out an external validation of the CLRSS, and to evaluate a modified version of the original CLRSS, that we named CLRSS-2. We conducted a retrospective analysis of 332 patients with recurrent laryngeal carcinoma treated in our center between 1985 and 2003. rTNM, CLRSS, and CLRSS-2 showed a monotonic prognostic gradient with increasing stage and produced significant differences in survival between stages. Discrepancies were detected in the cross-tabulation between rTNM and CLRSS. The CLRSS-2 achieved the best results in an objective comparison of the staging systems evaluated. The CLRSS-2 was the best method to classify patients with a recurrent laryngeal carcinoma.