[Treatment and prognosis of stage T3 glottic laryngeal cancer--a report of 65 cases]

Abstract

Background & objective: Clinical treatment of stage T3 glottic laryngeal cancer still remains controversial. This study was to explore the influences of different treatment modalities, lymph node metastasis, and positive margin on prognosis of stage T3 glottic cancer.

Methods: Records of 65 stage T3 glottic cancer patients, treated in Cancer Center of Sun Yat-sen University from Jan. 1, 1990 to Dec. 30, 1998, were retrospectively analyzed. The influences of different treatments, lymph node metastasis, and positive margin on survival of the patients were analyzed.

Results: The 3- and 5-year overall survival rates were 75.47% and 65.07%. No significant difference was found among surgery alone, radiotherapy alone, and surgery plus adjuvant radiotherapy groups (P=0.914), between partial laryngectomy and total laryngectomy groups (P=0.710), and between positive margin and negative margin groups (P=0.176). The lymph node metastasis rate was 18.5%, and the occult lymph node metastasis rate was 10.8%. Lymph node metastasis was a poor prognostic factor (P<0.001).

Conclusions: The influences of different treatments on survival of stage T3 glottic cancer patients are similar, and the effects of partial laryngectomy and total laryngectomy are also similar. Lymph node metastasis affects prognosis, and wait-and-see is recommended to cN0 patients. The survival of patients with positive margin after postoperative radiotherapy is similar to that of patients with negative margin.