The Prognostic Value Of Postoperative Adjuvant Therapy In Patients With Laryngeal Squamous Cell Carcinoma

Objective: To evaluate the prognostic value of postoperative adjuvant therapy in patients withearly and late laryngeal squamous cell carcinoma(LSCC).Including:the factors of patients : theage ,sex and KPS;the factors of tumor: pathology stage, tumor location, degree of tumordifferentiation, clinical stage;the factors of treatment: postoperative treatment modality , doseof radiation ,interval between surgery and radiation, In order to find the independent prognosticfactors affecting tumor recurrence time and long-time survival of laryngeal squamous cellcarcinoma, then guiding clinical treatment better.Methods: This was a retrospective study. 463 patients with LSCC treated by different strategyafter surgery in Shanxi tumor Hospital between 2000 and 2009 were enrolled in furtherretrospective analysis. Analyzing the prognostic factors affecting tumor recurrence time and longtimesurvival of laryngeal squamous cell carcinoma. Survival analysis was performed by the KMmethod, comparison among groups was performed by log-rank test and multivariate analysiswas carried out with the Cox proportional hazard model.Results The median survival time was 59.97 months, the 2- and 5-year survival rate was 86.9%and 51% respectively and the 2- and 5-year disease-free survival rate was 81%and43%.Postoperative concurrent radio-chemotherapy significantly improve the overall survival inthe patient with Locally advanced laryngeal squamous cell carcinoma when compared withpostoperative radiotherapy and surgery alone. Univariate analysis showed:age, KPS, pathologystage , tumor location, interval between surgery and radiotherapy, dose of radiation , treatmentmodality, were prognostic factors. Multivariate analysis showed that age, tumor location,treatment modality, pathology stage were independent prognostic factors.Conclusions:(1) Early staging laryngeal cancer patients do not need further postoperativetreatment. (2) for locally advanced patients, postoperative concurrent chemo-radiotherapysignificantly improve the overall survival compared with postoperative radiotherapy and surgeryalone. (3)age, tumor location,treatment modality, pathology stage were independent prognosticfactors. (4)The factors of tumor has no more relationgship with the prognostic.Compared withthese,the factors from patients and treatment were more important.