Prognostic value of tumor volume in patients with head and neck squamous cell carcinoma treated with primary surgery

BackgroundTumor volume in head and neck squamous cell carcinoma (HNSCC) was mainly measured in nonsurgically treated patients. We analyzed the influence of tumor volume on complete response (CR), overall survival (OS), and clear surgical margins also in primarily surgically treated patients. MethodsIn contrast-enhanced CTs, the tumor volumes of patients with incident HNSCC were measured. ResultsThe tumor volumes of 259 patients were measured, of which 125 patients (48%) underwent primary surgery and 102 patients (84%) had clear margins. The tumor volume was not an independent factor for CR at the primary tumor site. Risk of death increased by 1.4% per mL of tumor volume (95% confidence interval [CI] 0.8%-2.0%; P<.001). The OS was better in patients treated with primary surgery, if the tumor volume was 12mL (P<.001). Risk of involved margins increased by 4.5% per mL of tumor volume (95% CI 0.9%-8.3%; P=.003). The predicted probability of clear margins was 80% in tumor volumes16mL. ConclusionThe tumor volume had an impact on CR, OS, and clear margins. The tumor volume may also aid in selecting HNSCC treatment.