Laringeal kanserde evre, kronik obstrüktif akciğer hastalığı ve ikinci primer malignitelerin prognostik etkisi: tek merkezli retrospektif kohort çalışması

Year 2025, Volume: 16 Issue: 3, 479 - 485, 30.09.2025

Mehmet Salim Demir , Emre Hafızoğlu

https://doi.org/10.18663/tjcl.1745750

Abstract

Amaç: Laringeal kanserde (LK) tümör evresi ve komorbid durumlar, iyi bilinen prognostik faktörlerdir; ancak bu değişkenlerin sağkalım üzerindeki kombine etkisi gerçek yaşam verilerinde yeterince kapsamlı şekilde araştırılmamıştır. Bu çalışmanın amacı, LK hastalarında tümörün evresi, komorbiditeler ve ikinci primer malignitelerin (İPM) uzun dönem sağkalım üzerine etkilerini değerlendirmektir.
Gereç ve Yöntemler: 2010–2023 yılları arasında kurumumuzda tedavi edilip takip edilen, histopatolojik olarak doğrulanmış laringeal skuamöz hücreli karsinom tanılı 130 hasta retrospektif olarak incelendi. Sağkalım analizleri Kaplan–Meier yöntemi ile yapıldı; prognostik faktörler Cox orantısal risk regresyon modeli kullanılarak değerlendirildi. Özellikle komorbiditelerin, KOAH’ın ve İPM’lerin prognostik etkileri araştırıldı.
Bulgular: Tüm kohortta ortalama genel sağkalım (OS) 87,1 ay olarak hesaplandı (%95 GA: 72,2–101,9). Metastatik hastalığı bulunanlarda OS anlamlı derecede daha kısa bulundu (ortalama: 10,2 ay; p < 0,001). En az bir komorbiditesi olanlarda OS 70,2 aya düşmüştü (p = 0,004). Metastatik hastalık, mortalite riskinde 4,9 kat artış ile ilişkiliydi (HR = 4,92; p < 0,001). SPM, 15 hastada (%11,5) saptandı ve üç hasta (%2,3) SPM nedeniyle kaybedildi. Çok değişkenli analizde, SPM (HR = 2,37; %95 GA: 1,48–3,79; p = 0,002) ve KOAH (HR = 1,88; %95 GA: 1,22–2,90; p = 0,008) bağımsız olarak olumsuz sağkalım öngördürücüleri olarak belirlendi.
Sonuç: Tümör evresi, komorbiditeler ve ikinci primer maligniteler, laringeal kanserli hastalarda sağkalımı hem bağımsız hem de sinerjistik olarak etkilemektedir. Bu bulgular, onkolojik tedaviyi komorbidite yönetimi ve dikkatli izlemle entegre eden multidisipliner bir yaklaşımın önemini ortaya koymaktadır.

Keywords

laringeal kanser , genel sağkalım , ikinci primer malignite , tümör evresi

Ethical Statement

This study was approved by the Ethics Committee of Van Training and Research Hospital (Approval Date: 04 July 2025; Approval Number: 2025-05-12) and conducted in accordance with the ethical standards of the institutional research committee and the 1964 Declaration of Helsinki and its later amendments.

Prognostic impact of stage, chronic obstructive pulmonary disease and second primary malignancies in laryngeal cancer: a single-center retrospective cohort study

Abstract

Aim: Tumor stage and comorbid conditions are well-established prognostic factors in laryngeal cancer (LC); however, their combined impact on survival has not been comprehensively evaluated in real-world settings. This study aimed to assess the effects of tumor stage, comorbidities, and second primary malignancies (SPMs) on long-term survival in patients with LC.
Material and Methods: We retrospectively analyzed data from 130 patients with histologically confirmed laryngeal squamous cell carcinoma who were treated and followed at our institution between 2010 and 2023. Survival outcomes were assessed using the Kaplan--Meier method and Cox proportional hazards regression. The prognostic impact of comorbidities, COPD, and SPMs was specifically evaluated.
Results: The mean overall survival (OS) for the entire cohort was 87.1 months (95% CI: 72.2--101.9). Patients with metastatic disease had significantly shorter OS (mean: 10.2 months; p < 0.001), and those with at least one comorbidity had a reduced OS of 70.2 months (p = 0.004). Metastatic disease was associated with a 4.9-fold increased risk of mortality (HR = 4.92; p < 0.001). SPMs occurred in 15 patients (11.5%), and three patients (2.3%) died due to SPMs. In multivariate analysis, both SPMs (HR = 2.37; 95% CI: 1.48--3.79; p = 0.002) and COPD (HR = 1.88; 95% CI: 1.22--2.90; p = 0.008) were identified as independent predictors of worse survival.
Conclusion: Tumor stage, comorbidities, and second primary malignancies independently and synergistically impact survival outcomes in patients with laryngeal cancer. These findings underscore the importance of a multidisciplinary care model that integrates oncologic treatment with comorbidity management and vigilant follow-up.

Keywords

laryngeal cancer , overall survival , second primary malignancy , tumor stage

Ethical Statement

This study was approved by the Ethics Committee of Van Training and Research Hospital (Approval Date: 04 July 2025; Approval Number: 2025-05-12) and conducted in accordance with the ethical standards of the institutional research committee and the 1964 Declaration of Helsinki and its later amendments.

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