A Novel Inflammation- and Nutrition-Based Prognostic System for Patients with Laryngeal Squamous Cell Carcinoma: Combination of Red Blood Cell Distribution Width and Body Mass Index (COR-BMI)

<div><p>Background</p><p>Laryngeal squamous cell carcinoma (LSCC) is a head and neck cancer type. In this study, we introduced a novel inflammation- and nutrition-based prognostic system, referred to as COR-BMI (Combination of red blood cell distribution width and body mass index), for LSCC patients.</p><p>Methods</p><p>A total of 807 LSCC patients (784 male and 23 female, 22–87 y of age) who underwent surgery were enrolled in this retrospective cohort study. The patients were stratified by COR-BMI into three groups: COR-BMI (0) (RDW ≤ 13.1 and BMI ≥ 25); COR-BMI (1) (RDW ≤ 13.1 and BMI < 18.5 or 18.5 ≤ BMI < 25; RDW > 13.1 and 18.5 ≤ BMI < 25 or BMI ≥ 25); or COR-BMI (2) (RDW > 13.1 and BMI < 18.5). Cox regression models were used to investigate the association between COR-BMI and cancer-specific survival (CSS) rate among LSCC patients.</p><p>Results</p><p>The 5-y, 10-y, and 15-y CSS rates were 71.6%, 60.1%, and 55.4%, respectively. There were significant differences among the COR-BMI groups in age (< 60 versus ≥ 60 y; P = 0.005) and T stage (T1, T2, T3, or T4; P = 0.013). Based on the results, COR-BMI (1 versus 0: HR = 1.76; 95% CI = 0.98–3.15; 2 versus 0: HR = 2.91; 95% CI = 1.53–5.54, P = 0.001) was a significant independent predictor of CSS.</p><p>Conclusion</p><p>COR-BMI is a novel inflammation- and nutrition-based prognostic system, which could predict long-term survival in LSCC patients who underwent surgery.</p></div

Cox Regression Analyses for Cancer-specific Survival in Laryngeal Squamous Cell Carcinoma.

<p>Cox Regression Analyses for Cancer-specific Survival in Laryngeal Squamous Cell Carcinoma.</p

Patients’ Clinicopathological Characteristics.

<p>Patients’ Clinicopathological Characteristics.</p

Patient selection process.

<p>Patient selection process.</p

Kaplan-Meier curves for CSS rates of subgroups.

<p>(A) Kaplan-Meier curves for CSS rates of LSCC patients categorized by COR-BMI score (0/1/2). (B) Kaplan-Meier curves for CSS rates of LSCC patients categorized by tumor subsite. Abbreviations: CSS = cancer-specific survival; LSCC = Laryngeal squamous cell carcinoma; COR-BMI = Combination of red blood cell distribution width and body mass index.</p

Overall survival for patients with supraglottic squamous cell carcinoma, by subregion.

<p>Overall survival for patients with supraglottic squamous cell carcinoma, by subregion.</p

Supraglottic squamous cell carcinomas have distinctive clinical features and prognosis based on subregion

<div><p>Objective</p><p>To analyze the clinicopathologic characteristics and prognosis of patients with squamous cell carcinoma localized to different supraglottic subregions.</p><p>Methods</p><p>Clinicopathologic data were reviewed retrospectively for 111 patients with supraglottic squamous cell carcinoma who were diagnosed between January 1, 1995 and December 31, 2005 and were initially treated with surgery. DNA from human papillomavirus (HPV) 16 and (or /and) HPV 18 were detected in all the 111 supraglottic carcinoma specimens using in situ hybridization. Survival analysis was performed by Kaplan-Meier analysis, factors were compared using log-rank test, and prognostic factors were determined using Cox proportional hazards model. The relationship between subregions and clinicopathologic factors was analyzed using Chi-square tests.</p><p>Results</p><p>HPV prevalence differed between patients with aryepiglottic fold carcinoma and ventricle carcinoma (<i>P</i> < .05). The local-regional control rates, overall survival rates or cancer specific survival rates were significantly different between different subregions. Univariate analysis indicated that pTNM classification, pN spread, and subregion were associated with prognosis (<i>P</i> < .05). Multivariate analysis indicated that pTNM classification and subregion were associated with supraglottic carcinoma prognosis. The survival rate was better for patients with carcinoma of the epiglottis or ventricular bands compared to those with carcinoma in the aryepiglottic fold or ventricle (<i>P</i> = .012).</p><p>Conclusions</p><p>Subregion may be a new prognostic factor for supraglottic squamous cell carcinoma. Different supraglottic carcinoma subregions have distinct clinical features such as HPV expression, lymph node metastasis rate, local-regional control and prognosis. Therefore, it is necessary to subdivide supraglottic squamous cell carcinomas into several subregion groups to individualize therapy.</p></div

Univariate factors influencing prognosis of supraglottic squamous cell carcinoma.

<p>Univariate factors influencing prognosis of supraglottic squamous cell carcinoma.</p

Factors influencing prognosis of patients with supraglottic squamous cell carcinoma.

<p>Factors influencing prognosis of patients with supraglottic squamous cell carcinoma.</p

Factors influencing prognosis of supraglottic squamous cell carcinoma in multivariate analysis.

<p>Factors influencing prognosis of supraglottic squamous cell carcinoma in multivariate analysis.</p