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Francisco M. González, MD, PhD; Juan A. Vargas, MD, PhD; Cristóbal López-Cortijo, MD, PhD; Raquel Castejón, BSc; Carmen Gorriz, MD; Rafael Ramírez-Camacho, MD, PhD; Isabel Millán, MS; Alberto Durántez, MD, PhD

Arch Otolaryngol Head Neck Surg. 1998;124:852-856.

Background  For laryngeal carcinoma, the present TNM clinical staging system does not seem completely satisfactory as a guide for providing a prognosis for survival. We believe that natural killer cell activity would probably have a role in a more reliable system. Therefore, we analyzed the disease outcome with previously untreated epidermoid carcinoma of the larynx, evaluating classic clinical and pathologic factors, as well as natural killer cell activity in peripheral blood samples of the patients.

Objectives  To determine the level of natural killer cell activity in patients with laryngeal carcinoma and to analyze the prognostic value of this finding when associated with other clinical and pathologic variables.

Design  Prospective cohort study of surveillance of laryngeal cancer. Mean follow-up of 42.8 months.

Settings  Tertiary care referral center and ambulatory and hospitalized care.

Participants  We compared 81 men (mean age, 62.4 years; range, 35-89 years) with laryngeal carcinoma with 44 healthy men serving as control subjects (mean age, 57.6 years; range, 37-82 years).

Results  Natural killer cell activity was significantly reduced in patients who had died of cancer-related causes in comparison with tumor-free survivors. Overall actuarial survival differed significantly in histologically assessed nodal involvement and low natural killer cell activity. Use of the Cox proportional hazards regression model showed that the factors that seem to have a prognostic effect on survival are histologically determined nodal involvement and low natural killer cell activity.

Conclusions  These results support the prognostic significance of the determination of pretreatment natural killer cell activity in peripheral blood samples from patients with laryngeal carcinoma and suggest that assessment of adding such a determination to the current tumor staging system is advisable.

From the Services of Otorhinolaryngology (Drs González, López-Cortijo, Gorriz, and Ramírez-Camacho), Internal Medicine I (Drs Vargas and Durántez and Ms Castejón), and Biostatistics (Ms Millán), Clínica Puerta de Hierro, Universidad Autónoma, Madrid, Spain.

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