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Prognostic Indicators of Le Tourneau et al for Survival in a Patient with a Squamous Cell Carcinoma of the Head and Neck

Purpose: To evaluate a patient with a squamous cell carcinoma of the head and neck using the prognostic indicators of Le Tourneau et al.

Description

Le Tourneau et al reviewed prognostic indicators for a patient with a squamous cell carcinoma of the head and neck. These can help identify a patient who may benefit from more aggressive management. The authors are from Centre Paul Strauss and Sainte-Barbe Clinic in Strasbourg, France.


Parameters affecting overall survival:

(1) age

(2) pathologic T stage

(3) pathologic N stage (alternatively total number of nodes involved, with >= 10 node worst)

 

Parameters affecting distant metastases-free survival:

(1) site of the cancer (worse for oropharynx and hypopharynx)

(2) pathologic N stage

(3) tumor volume (worse when tumor volume is > 15 cubic cm)

 

Parameters affecting recurrence-free survival:

(1) site of the cancer

(2) pathologic T stage

(3) pathologic N stage

(4) cell differentiation (poorly differentiated best, undifferentiated worst)

 

Based on the data shown in Table 3 (page 805) I tried to derive a score for predicting overall survival.

 

Parameter

Finding

Points

age in years

<= 60 years

0

 

> 60 years

1

pathologic T stage

pT1

0

 

pT2 or pT3

1

 

pT4

2

pathologic N stage

pN0

0

 

pN1 or pN2a

1

 

pN2b or pN2c

2

 

pN3

4

 

where:

• The points are assigned based on relative risks shown in Table 3, page 805.

 

total score =

= SUM(points for all 3 factors)

 

Total Score

Overall Survival

0

good

1

fair

2 or 3

guarded

4 or 5

poor

6 or 7

very poor

 


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Specialty

Objective

ICD-10