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Efficacy of laryngectomy alone for treatment of locally advanced laryngeal cancer: A stage- and subsite-specific survival analysis.
- Source :
-
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery [Clin Otolaryngol] 2018 Apr; Vol. 43 (2), pp. 544-552. Date of Electronic Publication: 2017 Nov 21. - Publication Year :
- 2018
-
Abstract
- Objective: Total laryngectomy is a well-established treatment for locally advanced laryngeal cancer. Evidence for the benefit of post-operative radiotherapy after laryngectomy in patients with locally advanced primaries and N0 or N1 nodal disease is limited. This study aimed to determine whether total laryngectomy alone is adequate therapy for certain patient subgroups with locally advanced laryngeal cancer.<br />Design: We performed a retrospective survival analysis of patients in the surveillance epidemiology and end results (SEER) database with locally advanced laryngeal cancer between 2004 and 2012.<br />Outcome Measures: Primary outcome measure was overall survival.<br />Results: For all patients with T3-4aN0-1 tumours, overall survival was worse for those treated with laryngectomy only when compared using the Kaplan-Meier with a log-rank test and when accounting for demographic and tumour data using a Cox multivariate regression. Other independent predictors of poor survival included age >65 years old, Medicaid or uninsured payor status, supraglottic primary and N1 nodal disease. Stage- and subsite-specific analysis revealed that patients with T4a primary tumours, N1 nodal disease and supraglottic subsite had worse overall survival when treated with laryngectomy alone. Alternatively, patients with T3 primary tumours, N0 nodal disease, glottic subsite had equivalent overall survival and disease-specific survival when treated with laryngectomy alone vs laryngectomy with post-operative radiotherapy.<br />Conclusion: Locally advanced laryngeal cancer patients with T3 primaries, no nodal disease or primaries of the glottis may not benefit from post-operative radiotherapy when treated with primary total laryngectomy.<br /> (© 2017 John Wiley & Sons Ltd.)
- Subjects :
- Aged
Carcinoma, Squamous Cell pathology
Female
Humans
Laryngeal Neoplasms pathology
Male
Middle Aged
Neoplasm Staging
Retrospective Studies
SEER Program
Survival Analysis
Survival Rate
United States
Carcinoma, Squamous Cell mortality
Carcinoma, Squamous Cell surgery
Laryngeal Neoplasms mortality
Laryngeal Neoplasms surgery
Laryngectomy
Subjects
Details
- Language :
- English
- ISSN :
- 1749-4486
- Volume :
- 43
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 29054118
- Full Text :
- https://doi.org/10.1111/coa.13018