Real-world surgical outcomes and prognostic factors in stage III–IVA laryngeal squamous cell carcinoma: a multicenter, retrospective, cohort study in northern Japan
Year: 2026
Type: article
Abstract: Background This study evaluated oncological outcomes in a multicenter, real-world cohort of patients with stage III and IVA laryngeal squamous cell carcinoma (LASCC) undergoing surgery and identified prognostic factors associated with recurrence and mortality to inform risk-adapted treatment strategies in the era of perioperative pembrolizumab. Methods A total of 381 patients with stage III–IVA LASCC who underwent curative-intent surgery at 13 hospitals in northern Japan were retrospectively analyzed. Clinical, pathological, treatment, and survival data, including disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS), were analyzed according to pretreatment clinical and postoperative pathological factors. Results In the 381 patients, the 3-year DFS, OS, and DSS rates were 64.2%, 85.2%, and 90.0% in stage III disease and 49.5, 75.4, and 78.9% in stage IVA disease, respectively. Multivariate Cox regression analysis showed that increasing age was independently associated with poorer survival in patients with stage III disease. High-risk pathological features (extranodal extension or positive surgical margins) were associated with significantly worse survival. Adjuvant concurrent chemoradiotherapy (CCRT) was infrequently administered, even to high-risk patients. Conclusions Patients with stage III disease demonstrated good outcomes after surgery, with younger age associated with better survival, whereas those with stage IVA disease or high-risk pathological features had worse survival. These findings provide prognostic information to inform risk-adapted perioperative treatment strategies.
Authors: Akira Ohkoshi, Katsunori Katagiri, Satoshi Kano, Kazutake Yagi, Hiroshi Idogawa, Satoshi Toyoma, Iori Kusaka, Takashi Kasai, Yukiko Saito, Kizuku Owada, Hisataka Ominato, Haruka Kaya, Eiichi Ishida, Kazuya Kurakami, Atsushi Yoshimura, Kenta Taguchi, Takuya Yoshida, Ryo Ishii, Kenjiro Higashi, Yukio Katori
Language: English
Topic: Head and Neck Cancer Studies
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,590
OpenAlex ID: W7223467481