Prognosis in laryngeal carcinoma: host factors

A personal series of 1171 patients with a laryngeal tumour seen in a 27-year period from 1962 to 1988 is reported. Of these patients, 763 were previously untreated and had a histologically proved squamous cell carcinoma. The interaction between the host factors (age, sex and general condition) and other tumour factors, and the effect of the host factors on survival were analysed. The maximum age incidence was the same in the two sexes but performance status (general condition) declined with increasing age. There was no relation between age and site or histological grade of the tumour. However, the incidence of T3-T4 tumours increased up to the seventh decade and then declined again. Age was not a significant predictor of survival when allowance was made for patients who were untreated, or who had died of intercurrent disease or a second primary tumour. Men were more likely to have a glottic tumour: these tumours presented at an earlier stage and were likely to be well differentiated, mainly because glottic T1 carcinoma is almost exclusively a male disease. When individual sites are examined the crude survival for supraglottic tumours in women is better than that in men because of a higher death rate from other diseases and other tumours in men. Sex had no other effect on survival. Good performance status was associated with lower T-stage but not quite significantly so. It was not associated with any other tumour parameters. Performance status significantly affected survival of treated patients, probably indicating that general condition affects the patient's ability to resist his tumour.