Validation of the composite laryngeal recurrence staging system

BACKGROUND. The Composite Laryngeal Recurrence Staging System (CLRSS) has been described recently as an improved alternative to the retreatment TNM system (rTNM) for staging patients with recurrent laryngeal squamous cell carcinoma. The objectives of this study were to validate the CLRSS and compare its use with the rTNM system. METHODS. A retrospective chart review was conducted of 67 patients with recurrent laryngeal squamous cell carcinoma who had their initial treatment between 1980 and 1992. The external validity of the CLRSS was assessed, and its ability to stage patients and to predict survival was compared with the rTNM system. RESULTS. The overall 2-year survival rate was 51% (34 of 67 patients). The rTNM system was unable to stage 12 patients (18%), whereas all patients could be staged using the CLRSS. The CLRSS predicted survival better than the rTNM system (c-statistic = 0.79). CONCLUSIONS. The newer CLRSS staging system for recurrent laryngeal carcinoma outperformed the rTNM system in its ability to stage more patients and to predict survival.