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Title: Association of clinical factors with survival outcomes in laryngeal squamous cell carcinoma (LSCC).
Authors: Fong, Pei Yuan
Tan, Sze Huey 
Lim, Darren Wan Teck 
Tan, Eng Huat 
Ng, Quan Sing 
Sommat, Kiattisa 
Tan, Daniel Shao Weng 
Ang, Mei Kim 
Keywords: Adult
Age Factors
Aged, 80 and over
Chemoradiotherapy, Adjuvant
Kaplan-Meier Estimate
Laryngeal Neoplasms
Lymphatic Metastasis
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging
Organ Sparing Treatments
Progression-Free Survival
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck
Issue Date: 2019
Publisher: Public Library of Science (PLoS)
Citation: Fong, Pei Yuan, Tan, Sze Huey, Lim, Darren Wan Teck, Tan, Eng Huat, Ng, Quan Sing, Sommat, Kiattisa, Tan, Daniel Shao Weng, Ang, Mei Kim (2019). Association of clinical factors with survival outcomes in laryngeal squamous cell carcinoma (LSCC).. PLoS One 14 (11) : e0224665-. ScholarBank@NUS Repository.
Abstract: AIM: Treatment strategies in laryngeal squamous cell cancer (LSCC) straddle the need for long term survival and tumor control as well as preservation of laryngeal function as far as possible. We sought to identify prognostic factors affecting LSCC outcomes in our population. METHODS: Clinical characteristics, treatments and survival outcomes of patients with LSCC were analysed. Baseline comorbidity data was collected and age-adjusted Charlson Comorbidity Index (aCCI) was calculated. Outcomes of overall survival (OS), progression-free survival (PFS) and laryngectomy-free survival (LFS) were evaluated. RESULTS: Two hundred and fifteen patients were included, 170 (79%) underwent primary radiation/ chemoradiation and the remainder upfront surgery with adjuvant therapy where indicated. The majority of patients were male, Chinese and current/ex-smokers. Presence of comorbidity was common with median aCCI of 3. Median OS was 5.8 years. On multivariable analyses, high aCCI and advanced nodal status were associated with inferior OS (HR 1.24 per one point increase in aCCI, P<0.001 and HR 3.52; p<0.001 respectively), inferior PFS (HR 1.14; p = 0.007 and HR 3.23; p<0.001 respectively) and poorer LFS (HR 1.19; p = 0.001 and HR 2.95; p<0.001 respectively). Higher tumor (T) stage was associated with inferior OS and LFS (HR 1.61; p = 0.02 and HR 1.91; p = 0.01 respectively). CONCLUSION: In our Asian population, the presence of comorbidities and high nodal status were associated with inferior OS, PFS and LFS whilst high T stage was associated with inferior LFS and OS.
Source Title: PLoS One
ISSN: 19326203
DOI: 10.1371/journal.pone.0224665
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