Treatment and prognosis of patients with recurrent laryngeal carcinoma: a retrospective study.

Introduction Although recurrent laryngeal carcinoma is a common clinical problem, the data regarding its natural history and prognostic factors are limited. The aims of this study were to evaluate the treatment outcomes of patients with recurrent laryngeal carcinoma and to identify the value of several prognostic factors. Methods A retrospective analysis of 224 consec­utive cases of recurrent laryngeal carcinoma, treated between 1996 and 2009, was performed. Overall survival was estimated using the Kaplan–Meier method. Log-rank test was employed to identify significant prognostic factors for overall survival. The Cox proportional hazards model was applied to identify covariates significantly associated with the aforementioned endpoint. Results The estimated 3-, 5- and 10-year survival rates of the entire patient sample were 56.6%, 46.4% and 39.2%, respectively. On univariate analysis, the age, smoking index, grade, primary site, initial T stage, initial UICC stage and nodal status of the primary tumor, as well as the disease-free interval, extent of the recurrence, suitable for surgery were all powerful prognostic factors for survival. On multivariate analysis, four variables retained statistical significance: the initial T stage, nodal status, extent of the recurrence and suitable for surgery. Conclusion Our result suggests that lower initial T stage, no initial cervical lymph node metastasis, only localrecurrence and patients suitable for salvage surgeryare favorable prognostic factors for overall survival of patients with recurrent laryngeal cancer.