In:
Cancer Science, Wiley, Vol. 108, No. 10 ( 2017-10), p. 2030-2038
Abstract:
We aimed to determine whether pretreatment metabolic tumor volume of the primary tumor (T‐ MTV ) or T classification would be a better predictor of laryngectomy‐free survival ( LFS ) and overall survival ( OS ) after chemoradiotherapy in patients with locally advanced laryngeal or hypopharyngeal cancer requiring total laryngectomy. We analyzed 85 patients using a Cox proportional hazards model and evaluated its usefulness by Akaike's information criterion. A T‐ MTV cut‐off value was determined by time‐dependent receiver operating characteristic curve analysis. Interobserver reliability for measuring T‐ MTV was estimated by the intraclass correlation coefficient ( ICC ). After adjustment for covariables, T‐ MTV , irrespective of whether a continuous or dichotomized variable, and T classification remained independent predictors of LFS and OS . Large T‐ MTV ( 〉 28.7 mL ) was associated with inferior LFS (hazard ratio [ HR ], 4.16; 95% confidence interval [ CI ], 1.97–8.70; P = 0.0003) and inferior OS ( HR , 3.18; 95% CI , 1.47–6.69; P = 0.004) compared with small T‐ MTV (≤28.7 mL ). The T‐ MTV model outperformed the T classification model in predicting LFS and OS ( P = 0.007 and 0.01, respectively). Three‐year LFS and OS rates for patients with small versus large T‐ MTV were 68% vs 9% ( P 〈 0.0001) and 77% vs 25% ( P 〈 0.0001), respectively, whereas those for patients with T2‐T3 versus T4a were 61% vs 31% ( P = 0.003) and 71% vs 48% ( P = 0.10), respectively. ICC was 0.99 (95% CI, 0.99–1.00). Given the excellent interobserver reliability, T‐ MTV is better than T classification to identify patients who would benefit from the larynx preservation approach.
Type of Medium:
Online Resource
ISSN:
1347-9032
,
1349-7006
DOI:
10.1111/cas.2017.108.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2017
detail.hit.zdb_id:
2115647-5
detail.hit.zdb_id:
2111204-6
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