Clinical study of advanced laryngeal carcinoma

In the present study, 37 patients with advanced laryngeal carcinoma (stage III and IV) were analyzed, who had been treated at St. Marianna University, School of Medicine between 1996 and 2007, based on the modified tumor, nodes and metastasis (TNM) classification by the international union against cancer (UICC, 6th edition, 2003). Before the modification of the TNM classification, total laryngectomy (TL) was our strategy of treatment for T3 and T4 patients. Those patients who refused TL received radiotherapy (low-dose concurrent chemoradiotherapy or radiotherapy alone). Five out of 16 cases in T3 who were classified under the 6th edition belonged to T2 under the previous edition, which made the treatment of T3 more difficult. The 5-year cause-specific survival rate of all cases was 63.9%, 81.3% in stage III, 46.8% in stage IV, 90.9% in the glottic type and 50% in the supraglottic type. A particularly significant difference was seen between these latter two types (p<0.05). Comparing the radiotherapy group and the TL group, the survival rate of T3 patients was 85.7% in the TL group and 67.5% in the radiotherapy group, which was not significant. In T4 patients, the survival rate was 20% in the radiotherapy group and 100% in the TL group (p<0.05). In the T3 and T4 patient radiotherapy groups, high-dose concurrent chemoradiotherapy should be used to improve the 5-year survival rate. (author)