Prognostic factors in laryngeal carcinoma. Experience in 296 male patients.

Abstract

Laryngeal cancer is the primary cause of death among patients with head and neck cancer in Argentina. Different prognostic factors have been incidentally dealt with in a number of articles, but there are few studies of prognostic variables, such as age, tobacco, and alcohol, using multifactorial analysis. Between 1969-1987, 296 male patients with epidermoid carcinoma of the larynx treated at the Institute of Oncology "Angel H. Roffo" were studied regarding prognostic factors of survival. The effect of age, tobacco, alcohol, histologic grade, extent of primary tumor, and cord mobility on survival were assessed by means of the Cox proportional-hazards model. The univariate analysis showed that primary tumor extent, nodal involvement, stage, alcohol intake, previous tracheostomy, and cord mobility were statistically significant predictors of survival. Multivariate analysis disclosed only nodal involvement, alcohol intake, and cord mobility as statistically significant variables in regard to survivorship. With these variables, a hazard index was calculated for each patient, and four risk groups were formed. Five-year survival rates were as follows: Group A, 79%; B, 69%; C, 47%; and D, 14% (A versus C, P < 0.005; A versus D, P < 0.005). This study confirmed the prognostic impact of nodal involvement and also showed the importance of cord fixation and alcohol drinking as predictors of survival.