Effects of Different Treatment Strategies and Tumor Stage on Survival of Patients with Advanced Laryngeal Carcinoma: A 15-Year Cohort Study

Abstract

Background Laryngeal cancer is the second most common cancer in the head and neck. Since laryngeal cancer management is a complex process, there is still no standard strategy to treat this disease in order to increase the survival rate of the patients especially among those with advanced form of the disease. Methods A cohort study was undertaken to analyze factors predicting survival of the patients in advanced stage laryngeal cancer in the Southern Iran among all patients newly diagnosed with laryngeal cancer between 2000 and 2015. Results Data of a total number of 415 patients who have had been diagnosed with advanced laryngeal cancer during this period was used for analysis. The patients' 1-, 3-, 5-, and 10-year survival rates were 81%, 62%, 53%, and 38%, respectively. Multivariable Cox regression analyses indicated a significant relationship between patients' survival and age at diagnosis (P < 0.001), disease stage (P = 0.002), tumor grade (P = 0.008), positive L. node (P = 0.008), and type of treatment (P < 0.001). As expected, treatment strategy was identified as the most effective factor in survival of the patients. According to the results, patients who undergone surgical treatment experienced a longer survival than those who received other treatments. Conclusion This study showed that the survival of patients depends on several factors, among which, treatment strategy is the most important. Combination of total laryngectomy plus chemoradiation provides superior local control and better survival compared to either radiotherapy or chemoradiation in patients with advanced laryngeal cancer.

Time between Diagnosis and Treatment of Hypopharynx and Larynx Cancer: Are Longer Delays Associated with Higher Discrepancy between Clinical and Pathological Staging?

“…Upstaging from cN0 to pN+ has a negative impact on OS, decreasing the 5-year survival rates to nearly one-half. 12 A statistical significance on OS and DSS was found in the present sample, in accordance with the literature, providing that survival was reduced to a half in pN+ despite appropriate postoperative radiation or chemoradiation. The poorest survival rate was observed in cN0/pN+ and cN +/pN+ patients with a 5-year OS of 64.9% and 44.2%, respectively, which is in accordance with other series.…”

“…The poorest survival rate was observed in cN0/pN+ and cN +/pN+ patients with a 5-year OS of 64.9% and 44.2%, respectively, which is in accordance with other series. 3 12 17 18 In our study, survival outcomes were not influenced by discrepancies between clinical and pathological staging, provably, due to slight staging differences. Most of the upstaging cases were cT3 to pT4 and cN1 to cN2.…”

“…The clinical and demographic characteristics of the present study correlate with other series regarding the age of presentation, male predominance, as well as high tobacco and alcohol consumption. 12 However, a more advanced local (cT3T4) and regional (cN + ) disease at diagnosis was presented in this cohort, probably because only patients that underwent primary laryngectomy or pharyngolaringectomy with neck dissection were included.…”

Investigation of the affective factors on the survival rate of patients with laryngeal cancer using Cox proportional hazards and Lin -Ying’s additive hazards models

“…Many cancer survivors, even those who enjoy a free treatment, should adapt themselves to the long-term effects of treatment and mental concerns, like fear of recurrence ( 9 ). Those patients who should be treated by total laryngectomy for treatment of laryngeal cancer, unfortunately completely lose their voice and their quality of life decreases in different dimensions ( 10 ). Therefore, preserving the larynx is the most important concern for laryngeal cancer patients.…”

Statin use associated with improved overall and cancer specific survival in patients with head and neck cancer

“…Although there has recently been an advancement of therapeutic modalities for head and neck cancer (HNC) [1], survival rates have remained low. In the face of poor prognosis, clinicians have begun to explore how dysregulation of metabolic systems impacts outcomes.…”