| Objectives: This was designed to evaluate the survival outcome of patients with laryngeal carcinoma and to investigate the prognostic factors for laryngeal carcinoma, as well as to explore the clinical treatment strategy for laryngeal carcinoma.Methods: From January 2000 to December 2008, 177 cases of laryngeal carcinoma treated in the Cancer Hospital of Shantou University Medical College were retrospectively analyzed. Clinical features including age, gender, primary site, T status, N status, clinical stages, types of treatment, and total laryngectomy, as well as treatment outcome were analyzed. Survival rate was evaluated with Kaplan-Meier. Log rank test was used in univariate analysis. Cox proportional hazard model was used in multivariate analysis.Results: The 2-year and 5-year overall survival rate in clinical-stageⅠ,Ⅱ,Ⅲ,Ⅳlaryngeal carcinoma were 91.5%, 76.9%, 61.1%, 52.5%, and 79.5%, 70.1%, 51.7%, 41.4%, respectively. The 5-year survival rate of glottic carcinoma (n=112) was better than supraglottic carcinoma (n=65) (69.9% vs. 40.4%) (P=0.000). Laryngeal preservation rate was significantly high in radiotherapy group than in surgery group (94.2% vs. 57.5%, P=0.000). No statistic significance was found in survival rates of stageⅠ/Ⅱlaryngeal carcinoma between surgery group and radiotherapy group. Patients with stageⅢorⅣdisease had significantly higher 5-year survival rate in surgery group than in radiotherapy group (76.9% vs. 37.2%, P=0.029; 58.1%vs. 25.7%,P=0.014). Patients with advanced supraglottic carcinoma had significantly higher 5-year survival rate in surgery group than in radiotherapy group (63.1% vs. 27.0%, P=0.012). Univariate analysis showed that primary site, clinical stage, T stage, N stage, and treatment modality were impact factors for survival status of laryngeal carcinoma(P=0.000,0.001,0.004,0.000,0.001, respectively). Cox proportional hazard mode revealed that T status, N status and treatment modality were independent factors for treatment outcome of laryngeal carcinoma.Conclusions: Survival rate of patients with laryngeal carcinoma reduces with the increase of T stage and N stage . T stage, N stage, and treatment modality were independent prognostic factors for treatment outcome of laryngeal carcinoma. Surgical treatment result in better survival for patients with stageⅢorⅣdisease compared with radiotherapy. The survival rate of glottic carcinoma is higher than supraglottic carcinoma. These data suggest that surgery is an optimal modality for patients with advanced laryngeal carcinoma. |
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