Validation of a prognostic model for predicting larynx preservation outcome (TALK score) in a Southern European population

• Jordi Marruecos-Querol ^[1] ; Jordi Rubió-Casadevall ^[2] ; Alicia Lozano ^[3] ; Maria Buxó ^[4] ; Montserrat Puigdemont ^[5] ; Isabel Linares ^[3] ; Isabel Planas ^[6] ; Jordi Vayreda ^[1] ; Beatriz Cirauqui ^[7] ; Miren Taberna ^[8] ; Vanesa Quiroga ^[7] ; Marc Tobed ^[9] ; Antoni Borés ^[9] ; Sonia Recalde ^[8] ; Maria Saigi ^[7] ; Eudald Felip ^[7] ; Aranzazu Eraso ^[1] ; Ricard Mesía ^[7]
  1. [1] Departamento de Oncología Radioterápica, Instituto Catalán de Oncología, ICO Girona, Girona, España
  2. [2] Departamento de Oncología Médica, Instituto Catalán de Oncología, Girona, España
  3. [3] Departamento de Oncología Radioterápica, Instituto Catalán de Oncología, L'Hospitalet de Llobregat, Barcelona, España
  4. [4] Instituto de Investigación Biomédica de Girona (IDIBGI), Girona, España
  5. [5] Unidad de Epidemiología y Registro de Cáncer de Girona, Grupo de Epidemiología Descriptiva, Genética y Prevención del Cáncer, IDIBGI, Instituto Catalán de Oncología, Girona, España
  6. [6] Departamento de Oncología Radioterápica, Instituto Catalán de Oncología, Badalona, España
  7. [7] Departamento de Oncología Médica, Instituto Catalán de Oncología, Badalona, España
  8. [8] Departamento de Oncología Médica, Instituto Catalán de Oncología, L'Hospitalet de Llobregat, Barcelona, España
  9. [9] Servicio de Otorrinolaringología, Hospital Dr. Trueta, Girona, España

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 25, Nº. 8 (August), 2023, págs. 2384-2392
• Idioma: inglés
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• Resumen

  • Objective Larynx preservation is the current standard for locally advanced (LA) laryngeal/hypopharyngeal tumors, but not all patients respond as expected. TALK score model measures four variables (T-staging, albumin levels, liquor consumption and Karnofsky score) to determine which cases are best suited to preservation treatment scheme. We aimed to validate this prognostic model in a Southern European population.

    Methods We retrospectively evaluated 175 patients diagnosed from July 2008 to December 2015 with LA laryngeal/hypopharyngeal carcinoma and treated with a laryngeal preservation scheme comprising induction chemotherapy followed by concomitant chemotherapy and radiotherapy. We applied the TALK score model to predict larynx preservation rate.

    Results Of the 175 patients evaluated, 96.6% were men, 98.3% were smokers and 77.1% misused alcohol. Tumors were laryngeal 66.3% vs 33.7% in hypopharynx, and all were either stage III (37.7%) or stage IV (62.3%). TALK prognostic subgroups were: good risk 40.0%; intermediate risk 52.5%; and poor risk 7.5%. With a median follow-up of 40.1 months, larynx preservation rate, laryngectomy-free survival and overall survival at 3 years was 84.5%, 63.7% and 68.2%, respectively. Although TALK score was not predictive of 3-year larynx preservation rate (good risk 85.5%; intermediate risk 83.1%; poor risk 91.6%), it was predictive of 3-year overall survival (good risk 81.9%; intermediate risk 62.9%; poor risk 33.5%) and 3-year laryngectomy-free survival (good risk 75.6%; intermediate risk 59.6%; poor risk 30.7%).

    Conclusion TALK model could predict OS and laryngectomy-free survival, helping clinicians to decide which patients should avoid laryngeal preservation and undergo laryngectomy after diagnosis.