Evaluation of the revised TNM classification in advanced laryngeal cancer

The latest revision of the UICCs TNM classification in 2002 subdivided advanced laryngeal carcinoma into the subcategories T4a and T4b, in order to emphasise the poor prognosis and inoperability of the latter group. Our study aims at evaluating the prognostic relevance of this subclassification. This retrospective analysis includes 163 patients treated for advanced laryngeal carcinoma between 1980 and 2002. The disease-free 5-year-survival rates for patients suffering from T4a and T4b laryngeal carcinoma were 32.4 and 6.7%, respectively ( P = 0.003). The T-category and free margins proved to be significant prognostic factors. The survival of patients suffering from T4a carcinoma proved to be independent of specific location and number of invaded structures. This study confirms the much poorer prognosis for patients suffering from T4b carcinoma and thus supports the modified TNM classification.