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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 12/2013

01-12-2013 | Original article

Importance of tumor volume in supraglottic and glottic laryngeal carcinoma

Authors: L.W. van Bockel, MD., E.M. Monninkhof, PhD., F.A. Pameijer, MD PhD., C.H.J. Terhaard, MD PhD.

Published in: Strahlentherapie und Onkologie | Issue 12/2013

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Abstract

Purpose

The aim of our study was to assess the prognostic value of tumor volume compared to and in addition to T-stage on local control (LC), disease-free survival (DFS), and overall survival (OS) in glottic and supraglottic laryngeal carcinoma patients.

Patients and methods

In 150 patients, we determined tumor volume on diagnostic CT scans. We applied crude and multivariable Cox regression analysis to relate volume (continuous), T-stage and the combination to 5-year DFS, OS, and LC. Before, we examined the linearity assumption of the association between volume and outcome with restricted cubic spline functions. Prognostic performance of the models was examined by determination of the model’s discrimination. Discriminative ability was determined with the C statistic referring to the ability to discriminate between patients who do and do not develop an event during follow-up.

Results

A strong association between tumor volume and DFS and OS was found. The restricted cubic spline plot did not indicate a non-linear relationship between tumor volume and DFS and local control. Tumor volume demonstrated a better discriminative ability to predict DFS and OS compared to T-stage (0.68 and 0.57 vs. 0.59 and 0.54, respectively). For local control, T-stage showed a higher discriminative ability than tumor volume (0.63 vs. 0.61). The combined model increased discriminative power (0.69).

Conclusion

Volume seems to be more important than T-stage in prediction of DFS or OS in laryngeal squamous cell carcinoma patients. Perhaps prediction of DFS, OS, and LC could be improved by including tumor volume into the staging process.
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Metadata
Title
Importance of tumor volume in supraglottic and glottic laryngeal carcinoma
Authors
L.W. van Bockel, MD.
E.M. Monninkhof, PhD.
F.A. Pameijer, MD PhD.
C.H.J. Terhaard, MD PhD.
Publication date
01-12-2013
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 12/2013
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-013-0467-2

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