Seeking Medical Assistance for Dysphonia Is Associated with an Improved Survival Rate in Laryngeal Cancer: Real-World Evidence

Abstract

(1) Background: Patients with laryngeal cancer usually present with dysphonia. However, some studies reported that the duration from dysphonia to cancer diagnosis has been prolonged significantly in recent years. This study aimed to evaluate that in the initial dysphonia-related diagnosis and the interval between the diagnosis of laryngeal cancer may affect the overall survival (OS). (2) Methods: The 1997–2013 Longitudinal Health Insurance Database was used in this study. A propensity score with 1-to-1 matching was applied to balance the baseline characteristics. The OS was examined by the Kaplan-Meier method and log-rank test. (3) Results: A total of 2753 patients with a first primary laryngeal cancer diagnosis were identified. The patients without prior dysphonia-related diagnosis (PD−) group did have a significantly worse five-year survival (p = 0.015) comparing with those with a prior dysphonia-related diagnosis (PD+) group among glottic cancer patients. The group with a shorter dysphonia-to-diagnosis interval had a better five-year OS than the prolonged group (p = 0.007) in laryngeal cancer. (4) Conclusions: Looking for medical assistance before a diagnosis of glottic cancer is associated with a better overall survival, while a diagnostic delay of more than 30 days from the first medical examination for dysphonia is associated with a worse outcome among in patients with laryngeal cancer.

The Same–Up–Down Staging System for Recurrent Early Glottic Cancer

“…Early-stage glottic squamous-cell carcinoma portends a very favorable prognosis compared to other types of head and neck cancer [1]. An aggressive approach to persistent hoarseness/dysphonia has been promoted since the previous century [17], and it has been recently shown how an early referral to an otolaryngologist, as measured by the dysphoniato-diagnosis interval, is even associated with improved survival [18]. A single-stage treatment based on surgical resection or definitive RT on the larynx is the best therapeutic option in terms of both survival and functional preservation, while no elective treatment of the neck's lymph nodes is necessary, as recently stressed in an analysis by the US National Cancer Database [19].…”