Analysis of related factors of surgical treatment effect on 215 patients with laryngeal cancer

Abstract

This study investigated the factors affecting the surgical treatment effect on patients with laryngeal cancer. The clinical data (including the sex, age, smoking index, drinking, primary tumor site, tumor (T) stage, lymph nodes (N) stage, tumor differentiation degree, tumor diameter, surgical method, lymph node metastasis and cervical lymph node dissection) of 215 patients with laryngeal cancer in The Central Hospital of Wuhan were analyzed retrospectively; the survival rate was calculated using the Kaplan-Meier method; log-rank test was used for single-factor analysis, while Cox proportional hazard regression model was used for multiple-factor analysis. The 215 patients were followed up after surgical treatment. The 1-, 3- and 5-year survival rates were 96.2, 78.0 and 72.5%, respectively. The results of single-factor analysis showed that the age, primary tumor site, tumor differentiation degree, T stage, N stage, smoking index, tumor diameter and lymph node metastasis had significant influence on the postoperative curative effect on patients (P<0.05), but the patient's age, drinking and surgical method had no correlation with the postoperative curative effect (P>0.05). Multiple-factor analysis revealed that the primary tumor site, T stage, N stage and lymph node metastasis were the independent risk factors affecting the surgical effect on patients with laryngeal cancer. The survival rate of laryngeal cancer is decreased with the increase of T stage and N stage. The survival rate of patients with supraglottic laryngeal cancer is higher than that of patients with glottic laryngeal cancer and subglottic laryngeal cancer, and the survival rate of patients with lymph node metastasis-positive laryngeal cancer is lower than that of patients with lymph node metastasis-negative laryngeal cancer. The main factors affecting the survival rate of laryngeal cancer are primary tumor site, T stage, N stage and lymph node metastasis.

Keywords: laryngeal cancer; multiple-factor analysis; prognosis; surgical treatment; survival rate.

Figure 1.

Postoperative survival curve of 215 patients with laryngeal cancer. It can be seen that the survival rate of patients with laryngeal cancer is decreased with time.

Figure 2.

Postoperative survival curves of patients with different primary tumor sites. It can be seen that the survival rate of patients with supraglottic laryngeal cancer is higher than that of patients with glottic and subglottic cancers. The Kaplan-Meier method shows that the 1-, 3- and 5-year survival rates of patients with supraglottic laryngeal cancer are 95.4, 89.5 and 72.6%, respectively. The 1-, 3- and 5-year survival rates of patients with glottic laryngeal cancer are 92.8, 88.9 and 58.3%, respectively. The 1-, 3- and 5-year survival rates of patients with subglottic laryngeal cancer are 86.4, 70.8 and 22.9%, respectively.

Figure 3.

Survival curves of patients with different T stages. The survival rates of patients in T1 and T2 stages are significantly higher than those in T3 and T4 stages.

Figure 4.

Survival curves of patients with different N stages. It can be seen that the survival rate of patients with laryngeal cancer in N0 stage is significantly higher than that in N1 and N2 stages; the 1-, 3- and 5-year survival rates of patients with laryngeal cancer in N0 stage are 95.4, 87.1 and 76.5%, respectively. The 1-, 3- and 5-year survival rates of patients with laryngeal cancer in N1 stage are 69.5, 58.7 and 49.4%, respectively. The 1-, 3- and 5-year survival rates of patients with laryngeal cancer in N2 stage are 56.4, 45.1 and 31.0%, respectively.

Figure 5.

Survival curves of patients with lymph node metastasis. The survival rate of lymph node metastasis-negative patients is significantly higher than that of lymph node metastasis-positive patients. The 1-, 3- and 5-year survival rates of lymph node metastasis-positive patients are 73.9, 68.8 and 24.5%, respectively.