الفهرس 
Epidemiological Prognostic FactorsOnly 14 pages are availabe for public view
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Abstract
Head-and-neck cancer is the sixth most prevalent cancer in the world, of all head and neck tumors, 30%-40% originate in the larynx. Laryngeal cancer is most frequently diagnosed among people aged 55-64. It is much more common in males. Smoking is the most important risk factor for laryngeal cancer. Laryngeal tumors are classified into supraglottic, glottic and subglottic tumors. Involvement of the glottis has generally been reported to be more common than the supraglottis, however in some Mediterranean and Latin American countries as well as our department, supraglottic carcinomas have been found to be more prevalent. The dominant histopathological subtype is the moderately differentiated invasive squamous cell carcinoma (grade II).The majority of patients present with locally advanced (stage III–IV), non metastatic (M0) disease. Surgery followed by postoperative radiation therapy (RT), or postoperative radiochemotherapy (RT-CHT) was used in operable cases. In inoperable cases, altered fractionated RT regimens, and combined RT-CHT are considered standard of treatment. The strongest effect of CHT was seen for concurrent RT-CHT.
Prognostic factors continue to play a critical role in advising individuals, choosing among different treatment options, stratifying for groups of comparable risks while designing new studies, interpreting the literature, and understanding the biologic nature of the laryngeal carcinoma. A failure to appreciate the importance of prognostic factors may contribute to the design of inefficient studies, the wrong interpretation of results, the development of an inconsistent literature and misunderstanding the effects of therapy.
The present retrospective analysis was therefore undertaken to identify potential prognostic factors in laryngeal cancer patients who presented to head and neck clinic from 2011 to 2013 at the department of Clinical Oncology and Nuclear Medicine, Ain Shams University. To improve our outcome and provide better practice, the most frequently mentioned prognostic factors affecting disease free survival and overall survival were evaluated in terms of epidemiological factors; patient factors; tumor factors and Management factors.
Nodal involvement is the most important statistically significant prognostic factor. Prognostic factors in laryngeal cancer patients should be studied on a larger scale and longer follow up period so as to develop a simple prognostic tool that matches our patients’ characteristics and our capabilities. So as to reach this goal we shall solve the problems that faced us in our study which don’t represent our department alone but the whole developing countries as well; starting a multidisciplinary team including nutrition specialized clinic and smoking cessation program. Also improving our data base by standardizing clinical check list sheets and nutrition sheets for history taking at first presentation for easy and precise collection of all important data needed to reach the best outcome.