[Survival of glottic carcinoma patients treated with definitive radiation therapy: value of the Sixth edition of the UICC TNM staging system].

Abstract

Purpose: To evaluate the survival of glottic carcinoma patients treated with radiation therapy (RT). The predictive value of the new sixth edition of the UICC staging system was also evaluated.

Methods and materials: 193 patients with T1-2N0 glottic squamous cell carcinoma, classified according to the fifth edition of the UICC staging system, were treated with definitive RT. Of them, 130 patients evaluated with pretreatment radiological examinations (CT and/or MR) were retrospectively classified according to the UICC sixth edition.

Results: According to the UICC fifth edition, 132 lesions were staged as T1 and 61 as T2. Thirty lesions were categorized as stage T3 according to the UICC sixth edition. Of all patients, 13 died of glottic carcinoma, 25 of second malignancy, and 20 of intercurrent disease. Second primary sites included lung (n=8), esophagus (n=4), liver (n=4), pancreas (n=3), and others (n=6). The 10-year overall survival rate was 66%, and cause-specific survival rates of glottic carcinoma and second malignancy were 91% and 86%, respectively. Multivariate analysis confirmed T-stage in the UICC sixth edition as an independent predictor for death from glottic carcinoma. Although there were no significant factors for second malignancy, there was no death from second malignancy in non-smoking patients.

Conclusion: Second malignancy was the most frequent cause of death, and an association with smoking was suggested. The UICC sixth edition appears to correctly identify patients with T3 lesions as a high-risk group not only for local failure but also for survival.