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

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Abstract

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.

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Data availability statement

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors received no specific funding for their participation in this work.

Author information

Authors and Affiliations

  1. Radiation Oncology Department, Catalan Institute of Oncology, ICO Girona, Girona, Spain

    Jordi Marruecos-Querol, Jordi Vayreda & Aranzazu Eraso

  2. Medical Oncology Department, Catalan Institute of Oncology, Girona, Spain

    Jordi Rubió-Casadevall

  3. Radiation Oncology Department, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Barcelona, Spain

    Alicia Lozano & Isabel Linares

  4. Girona Biomedical Research Institute (IDIBGI), Girona, Spain

    Maria Buxó

  5. Epidemiology Unit and Girona Cancer Registry, Descriptive Epidemiology, Genetics and Cancer Prevention Group, IDIBGI, Catalan Institute of Oncology, Girona, Spain

    Montserrat Puigdemont

  6. Radiation Oncology Department, Catalan Institute of Oncology, Badalona, Spain

    Isabel Planas

  7. Medical Oncology Department, Catalan Institute of Oncology, Badalona, Spain

    Beatriz Cirauqui, Vanesa Quiroga, Maria Saigi, Eudald Felip & Ricard Mesía

  8. Medical Oncology Department, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Barcelona, Spain

    Miren Taberna & Sonia Recalde

  9. Otorhinolaryngology Department, Dr. Trueta Hospital, Girona, Spain

    Marc Tobed & Antoni Borés

Authors
  1. Jordi Marruecos-Querol
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  15. Maria Saigi
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Correspondence to Jordi Marruecos-Querol.

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Marruecos-Querol, J., Rubió-Casadevall, J., Lozano, A. et al. Validation of a prognostic model for predicting larynx preservation outcome (TALK score) in a Southern European population. Clin Transl Oncol 25, 2384–2392 (2023). https://doi.org/10.1007/s12094-023-03121-9

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