Patterns of recurrence after open partial horizontal laryngectomy types II and III: univariate and logistic regression analysis of risk factors

摘要

In choosing the best surgical treatment (total or partial laryngectomy) for patients affected by laryngeal squamous cell carcinoma (SCC), itis still necessary to identify a link between prognostic factors and oncological outcomes. A retrospective analysis of clinical outcomes of819 patients affected by laryngeal cancer who underwent OPHL type II and III between 1995 to 2014 was carried out. Focusing on recurrenceand its site (local, regional or distant), our cohort has been divided in two groups: patients showing recurrence (n = 108) vs thosewithout recurrence (n = 711). Thirteen clinical-pathological parameters have been studied by univariate and multivariate analysis to identifypossible correlations between recurrence and oncological outcomes (overall survival (OS), disease free survival (DFS), disease specific survival(DSS), laryngectomy free survival (LSF), laryngectomy free freedom (FFL). In multivariate analysis, we found 4 negative prognosticfactors for recurrence: site of tumour ( supraglottic), cartilage invasion ( if present), perineural invasion ( if present) and type of OPHL( in OPHL type III). The knowledge and detection of negative prognostic factors for the risk of recurrence (pN classification, cartilageinvolvement, perineural invasion, and thus the type of surgical treatment adopted) could increase the already well-established potentialityof OPHLs in treating cases with a safe indication after careful discussion in the tumour board.