Akademik Veri Yönetim Sistemi
Master Of Head and Neck Surgery IFHNOS 2025, İstanbul, Türkiye, 13 - 15 Kasım 2025, ss.13, (Tam Metin Bildiri)
Objective
To evaluate clinicopathological prognostic factors influencing overall survival (OS) and disease-free survival (DFS) in patients with advanced-stage laryngeal carcinoma treated surgically.
Materials and Methods
One hundred thirty-two patients who underwent total or partial laryngectomy between 2010 and 2020 were analyzed retrospectively. Pathological specimens, medical records, and follow-up data were reviewed. The mean follow-up period was 44.7 ± 33.5 months (range: 1–126). Clinicopathological variables, including tumor T stage, differentiation, lymphovascular and perineural invasion, lymph node metastasis, thyroid and cricoid cartilage invasion, extranodal extension (ENE), and surgical margin status, were evaluated for their effects on OS and DFS. All cases were re-evaluated by the same multidisciplinary head and neck oncology team to ensure consistent staging and histopathologic assessment.
Results
At the end of follow-up, OS and DFS rates were 69.7% and 78.8%, while 5-year OS and DFS were 75.1% and 78.5%. Higher T stage was significantly associated with reduced OS (p<0.05) but not DFS (p>0.05). Partial laryngectomy (n=35) yielded substantially better OS than total laryngectomy (n=97) (p<0.05), with no difference in DFS (p=0.242). Thyroid cartilage invasion adversely affected both OS and DFS (p<0.05), while cricoid cartilage and lymphovascular invasion were not significant (p>0.05). ENE was correlated with poorer OS and DFS (p<0.05). Multiple lymph node metastases reduced OS (93.8% vs 50.0%, p<0.05). Recurrence markedly worsened OS (78.3% vs 11.8%, p<0.001). CD8⁺ T-cell infiltration (>50 cells/mm²) was found in 69.7% of cases and tended to associate with better OS.
Conclusions
Advanced T stage, thyroid cartilage invasion, extranodal extension, multiple lymph node metastases, and recurrence were identified as major adverse prognostic factors for survival in surgically treated advanced laryngeal carcinoma, consistent with existing literature. These findings may help refine patient selection for conservative surgery and highlight the predictive role of immune microenvironment markers such as CD8⁺ T-cell density.