Prognostic value of total tumor volume in advanced‐stage laryngeal and hypopharyngeal carcinoma

BACKGROUND: To evaluate the prognostic value of total tumor volume (TTV) in patients with laryngeal and hypopharyngeal carcinomas. METHODS: This study involved 182 patients with previously untreated advanced-stage squamous cell carcinoma of the larynx or hypopharynx. TTV were calculated from pretreatment contrast-enhanced computed tomography images. Univariate and multivariate analyses were used to identify factors associated with overall (OS), disease-specific (DSS), and disease-free survival (DFS). RESULTS: At a median follow-up of 63 months (range, 24-139 months), the 5 year OS, DSS, and DFS rates were 60.2%, 73.1%, and 69.4%, respectively. Multivariate analyses showed that tumor site was an independent predictor of DSS (P = 0.03); Charlson comorbidity index for OS (P = 0.001); second primary cancer for OS (P = 0.008) and DFS (P = 0.001); and vocal fold paralysis for DSS (P = 0.014) and DFS (P = 0.033). Extension to the tongue base was an independent predictor of OS (P = 0.007), DSS (P < 0.001), and DFS (P = 0.017), and TTV ≥8.38 ml was an independent predictor of all three survivals (P < 0.001 each). CONCLUSION: Radiologically determined TTV is prognostic of survival in patients with advanced-stage laryngeal and hypopharyngeal carcinoma.