Predicting Local Recurrence in T3 Laryngeal Squamous Cell Carcinoma: An Analysis of Tumor Volume and Cartilage Invasion Prior to Radiotherapy.

INTRODUCTION: Patients with T3 laryngeal squamous cell carcinoma (LSCC) face a high risk of local recurrence after chemoradiotherapy (CRT) or radiotherapy (RT). This study examines whether tumor volume and inner cortex cartilage invasion (ICCI) predict local recurrence and survival. MATERIALS AND METHODS: Eighty-six patients with T3 LSCC, treated with RT or CRT at the Karolinska University Hospital between 2005 and 2021, were included. Cox regression assessed the effect of associations between tumor volume and ICCI on local failure and 5-year mortality, adjusting for treatment modality, tumor subsite, and vocal cord mobility. RESULTS: High tumor volume (> 5 mL) was associated with a threefold increase in local failure risk (HR 3.11, 95% CI 1.47-6.55). No significant associations were found between tumor volume and mortality, ICCI and local failure, or ICCI and mortality. CONCLUSION: The results demonstrate that a larger tumor volume correlates with a reduced treatment response for patients with T3 LSCC treated with RT or CRT.