Evaluation of Risk Factors for Laryngeal Squamous Cell Carcinoma: A Single-Center Retrospective Study

Abstract

Background: The survival rate of patients with laryngeal squamous cell carcinoma (LSCC) is correlated with several factors. However, the independent prognostic factors of patients with LSCC remain unclear. Thus, we sought to identify prognostic factors affecting LSCC outcomes in the Chinese population.

Methods: The survival and potential prognostic factors of 211 patients with LSCC between April 2011 and July 2019 were retrospectively analyzed. Overall survival (OS) and progression free survival (PFS) were estimated by the Kaplan Meier method, and a log-rank test was used to compare the possible prognostic factors between different groups. The Cox proportional hazard model was used to perform multivariable analysis of significant covariants.

Results: A total of 211 LSCC patients were included, of which 164 (77.7%) were male and 47 (22.3%) were female. Mean age was 62.19 ± 8.328 years. A univariate analysis showed that seven factors including pathological differentiation, clinical stage, tobacco consumption, alcohol consumption, T stage, N stage, and concurrent chemoradiotherapy were correlated with survival (P<0.05). Cox proportional hazards regression analyses revealed that clinic stage (hazard ratio=3.100, p=0.048), pathological differentiation (hazard ratio = 2.538, p=0.015), alcohol consumption (hazard ratio = 8.456, p =0.004) were associated with OS in LSCC. Pathological differentiation (hazard ratio =5.677, p=0.000), alcohol consumption (hazard ratio =6.766, p=0.000) were associated with PFS in LSCC.

Conclusions: Pathological differentiation, alcohol consumption, are independent prognostic factors and predictors of recurrence in LSCC. These factors could help inform guidelines for clinical treatment and prognosis.

Keywords: Chinese population; laryngeal squamous cell carcinoma; overall survival; prognostic factors; progression-free survival.

Figure 1

Kaplan.-Meier curves for overall survival (OS). (A) Kaplan-Meier curves for overall survival rate. (B) There was no significant differences between male and female, p>0.05. (C) There was no significant differences among age group, p>0.05. (D) The survival rate for tabacoo users was significantly lower than non-smokers, p=0.005. (E) The survival rate for those who used to drink was significantly lower than those did not, p=0.001. (F) There was no significant difference among group of type, p>0.05. (G) The survival rate for those with low pathological differentiation tumors was significantly lower than those were high, p=0.000. (H) The survival rate for patients with clinical stage IV was significantly lower than those with I, II, III, respectively, p=0.001. (I) The survival rate for those at stage T3 and T4 was significantly lower than those at T1 and T2, p=0.017. (J) The survival rate for those at stage N2 and N3 was significantly lower than those at N1 and N0, p<0.05. (K) The survival rate for those with concurrent chemoradiotherapy was significantly lower than those not, p<0.05.

Figure 2

Kaplan-Meier curves of progression free survival (PFS) probability against time. (A) Kaplan-Meier curves for PFS. (B) There was no significant differences between male and female, p>0.05. (C) There was no significant differences among age group, p>0.05. (D) The PFS rate for tabacoo users was significantly lower than non-smokers, p=0.008. (E) The PFS rate for those who used to drink was significantly lower than those did not, p=0.000. (F) There was no significant difference among group of type, p>0.05. (G) The PFS rate for those with low pathological differentiation tumors was significantly lower than those were high, p=0.000. (H) The PFS rate for patients with clinical stage IV was significantly lower than those with I, II, III, respectively, p=0.000. (I) The PFS rate for those at stage T3 and T4 was significantly lower than those at T1 and T2, p=0.024. (J) The PFS rate for those at stage N2 and N3 was significantly lower than those at N1 and N0, p<0.05. (K) The PFS rate for those with concurrent chemoradiotherapy was significantly lower than those not, p<0.05.