TY - JOUR
T1 - New clinical severity staging system for cancer of the larynx
T2 - Five-year survival rates
AU - Piccirillo, Jay F.
AU - Sasaki, Clarence T.
AU - Wells, Carolyn K.
AU - Feinstein, Alvan R.
N1 - Funding Information:
From the Robert Wood Johnson Clinical Scholars Program (Piccirillo, Wells, Feinstein) and the Departments of Surgery (Otolaryngology [Sasaki, Piccirillo]) and Medicine and Epidemiology (Feinstein), Yale University School of Medicine, New Haven, Connecticut. Dr Piccirillo is the recipient of the 1993 Junior Faculty Research Award from the American Laryngological Association and a Junior Clinical Research Award from the American Cancer Society (grant JCRA-1).
PY - 1994/2
Y1 - 1994/2
N2 - Although statistics for cancer of the larynx are reported according to the tumor, node, metastasis (TNM) morphological staging system, functional clinical distinctions can identify major prognostic differences within the same morphological stage. This study was done to improve the staging system by incorporating pertinent clinical variables. In 193 patients with cancer of the larynx first treated between 1973 and 1985, the total 5-year survival was 66% (127/193). By TNM stage it was I, 78% (60/77); II, 67% (32/48); III, 60% (27/45); and IV, 35% (8/23). In three new functional severity stages that combined symptom severity and comorbidity, the corresponding rates were alpha, 83% (89/107); beta, 58% (34/59); and gamma, 15% (4/27). The functional severity stages could be combined with TNM stages to create a powerful new clinical severity staging system, in which the survival results were A, 88% (53/60); B, 80% (24/30); C, 63% (38/60); and D, 28% (12/43). These results demonstrate that inclusion of clinical variables in a formal staging system can strikingly improve prognostic estimations and classification of patients.
AB - Although statistics for cancer of the larynx are reported according to the tumor, node, metastasis (TNM) morphological staging system, functional clinical distinctions can identify major prognostic differences within the same morphological stage. This study was done to improve the staging system by incorporating pertinent clinical variables. In 193 patients with cancer of the larynx first treated between 1973 and 1985, the total 5-year survival was 66% (127/193). By TNM stage it was I, 78% (60/77); II, 67% (32/48); III, 60% (27/45); and IV, 35% (8/23). In three new functional severity stages that combined symptom severity and comorbidity, the corresponding rates were alpha, 83% (89/107); beta, 58% (34/59); and gamma, 15% (4/27). The functional severity stages could be combined with TNM stages to create a powerful new clinical severity staging system, in which the survival results were A, 88% (53/60); B, 80% (24/30); C, 63% (38/60); and D, 28% (12/43). These results demonstrate that inclusion of clinical variables in a formal staging system can strikingly improve prognostic estimations and classification of patients.
KW - comorbidity
KW - laryngeal neoplasms
KW - neoplasm staging
KW - neoplasms
KW - prognosis
KW - squamous cell carcinoma
KW - survival rate
UR - http://www.scopus.com/inward/record.url?scp=0028343985&partnerID=8YFLogxK
U2 - 10.1177/000348949410300201
DO - 10.1177/000348949410300201
M3 - Article
C2 - 8311395
AN - SCOPUS:0028343985
SN - 0003-4894
VL - 103
SP - 83
EP - 92
JO - Annals of Otology, Rhinology and Laryngology
JF - Annals of Otology, Rhinology and Laryngology
IS - 2
ER -