Survival after refusal of surgical treatment for locally advanced laryngeal cancer

Osazuwa-Peters, Nosayaba; Franco, Joel; Ward, Gregory W.; Walker, Rebecca

doi:10.1016/j.oraloncology.2017.05.019

Cited by 22 publications

(35 citation statements)

References 36 publications

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“…Depression may be more common in this head and neck subanatomic site due to treatment intensity or the resulting functional and esthetic deficits experienced by these patients. The burden of these deficits is such that some patients may decline a recommended and potentially lifesaving treatment such as laryngectomy in order to avoid a stoma and to preserve their voice and appearance …”

Section: Discussionmentioning

confidence: 99%

Prevalence and sociodemographic factors associated with depression among hospitalized patients with head and neck cancer—Results from a national study

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Prevalence and sociodemographic factors associated with depression among hospitalized patients with head and neck cancer—Results from a national study

et al. 2018

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“…The potential reason to explain the unfavorable prognosis of widower individuals is undertreatment. Several studies have indicated that single patients were more likely to have delayed treatment or refuse treatment than patients who were married 25 , 26 . However, further subgroup analysis of single patients was not performed in these studies.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Marital Status on Nasopharyngeal Carcinoma Survival: A Surveillance, Epidemiology and End Results Study

Wu¹,

Zhang²,

Zhang³

et al. 2018

J. Cancer

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Purpose: This study examined the role of marital status on survival outcome of nasopharyngeal carcinoma (NPC) patients using a population-based cancer registry.Methods: Patients with primary NPC diagnosed between 2004 and 2013 were included using the Surveillance, Epidemiology and End Results program. Patient demographic, clinicopathologic features, management, and survival outcomes were compared according to marital status. Cause-specific survival (CSS, NPC-related death) for marital status was analyzed.Results: The data of 3018 patients were included, with 61.4%, 11.1%, 21.8, and 5.6% of patients married, divorced (or separated), single, and widowed, respectively. Widowed patients had the highest proportion of elderly age (p < 0.001), were more likely to be female (p < 0.001), and had more well-to-moderately differentiated (p < 0.001) and node-negative disease (p = 0.038). Widowed patients were also less likely to have received radiotherapy and chemotherapy compared with patients of other marital status (p < 0.001). The 5-year CSS was 76.1%, 70.8%, 73.4%, and 59.8% in the married, divorced, single, and widowed groups, respectively (p = 0.001). Marital status was the independent prognostic factor for CSS. Widowed patients had a significantly increased risk of NPC-related death compared with married (hazard ratio [HR] 2.014, 95% confidence interval [CI] 1.477-2.747, p < 0.001), divorced (HR 1.580, 95% CI 1.087-2.295, p = 0.017), and single (HR 2.000, 95% CI 1.402-2.854, p < 0.001) patients. The divorced (p = 0.067) and single (p = 0.949) groups had similar CSS to the married group.Conclusions: Being widowed was associated with an increased the risk of cancer mortality in NPC compared with being married, divorced, or single.

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“…The existing published case series literature on T 3 laryngeal cancers reports combined five-year overall survival rates ranging from 36 to 67 per cent for non-surgical treatment, and 41 to 60 per cent for surgical treatment. 3–7 Our experience of treatment outcomes for non-surgical management (five-year overall survival rate for chemoradiotherapy of 48.6 per cent) lies within this range. However, our surgical management outcomes (five-year overall survival rate of 34.1 per cent) falls just short of that quoted in the literature, and is short of the rate (of over 57 per cent) reported at Cumberland Infirmary.…”

Section: Discussionmentioning

confidence: 86%

“…Following this, numerous case series have studied the survival outcomes of patients with T 3 laryngeal carcinoma. [3][4][5][6][7] It has been suggested that chemoradiotherapy offers a significant increase in five-year overall survival when compared to total laryngectomy with post-operative adjuvant radiotherapy (RT). 3 Others were not able to identify any significant difference in survival between surgical and non-surgical treatment, 4 and some have even shown that surgical treatment offers significantly higher rates of survival.…”

Section: Introductionmentioning

confidence: 99%

Treatment outcomes of laryngectomy compared to non-surgical management of T₃ laryngeal carcinomas: a 10-year multicentre audit of 179 patients in the northeast of England

Lin¹,

Goodfellow

Ong

et al. 2020

J. Laryngol. Otol.

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ObjectiveWide-ranging outcomes have been reported for surgical and non-surgical management of T3 laryngeal carcinomas. This study compared the outcomes of T3 tumours treated with laryngectomy or (chemo)radiotherapy in the northeast of England.MethodsThe outcomes of T3 laryngeal carcinoma treatment at three centres (2007–2016) were retrospectively analysed using descriptive statistics and survival curves.ResultsOf 179 T3 laryngeal carcinomas, 68 were treated with laryngectomies, 57 with chemoradiotherapy and 32 with radiotherapy. There was no significant five-year survival difference between treatment with laryngectomy (34.1 per cent) and chemoradiotherapy (48.6 per cent) (p = 0.184). The five-year overall survival rate for radiotherapy (12.5 per cent) was significantly inferior compared to laryngectomy and chemoradiotherapy (p = 0.003 and p < 0.001, respectively). The recurrence rates were 22.1 per cent for laryngectomy, 17.5 per cent for chemoradiotherapy and 50 per cent for radiotherapy. There were significant differences in recurrence rates when laryngectomy (p = 0.005) and chemoradiotherapy (p = 0.001) were compared to radiotherapy.ConclusionLaryngectomy and chemoradiotherapy had significantly higher five-year overall survival and lower recurrence rates compared with radiotherapy alone. Laryngectomy should be considered in patients unsuitable for chemotherapy, as it may convey a significant survival advantage over radiotherapy alone.

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Survival after refusal of surgical treatment for locally advanced laryngeal cancer

Cited by 22 publications

References 36 publications

Prevalence and sociodemographic factors associated with depression among hospitalized patients with head and neck cancer—Results from a national study

Prevalence and sociodemographic factors associated with depression among hospitalized patients with head and neck cancer—Results from a national study

The Effect of Marital Status on Nasopharyngeal Carcinoma Survival: A Surveillance, Epidemiology and End Results Study

Treatment outcomes of laryngectomy compared to non-surgical management of T₃ laryngeal carcinomas: a 10-year multicentre audit of 179 patients in the northeast of England

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Survival after refusal of surgical treatment for locally advanced laryngeal cancer

Cited by 22 publications

References 36 publications

Prevalence and sociodemographic factors associated with depression among hospitalized patients with head and neck cancer—Results from a national study

Prevalence and sociodemographic factors associated with depression among hospitalized patients with head and neck cancer—Results from a national study

The Effect of Marital Status on Nasopharyngeal Carcinoma Survival: A Surveillance, Epidemiology and End Results Study

Treatment outcomes of laryngectomy compared to non-surgical management of T3 laryngeal carcinomas: a 10-year multicentre audit of 179 patients in the northeast of England

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Treatment outcomes of laryngectomy compared to non-surgical management of T₃ laryngeal carcinomas: a 10-year multicentre audit of 179 patients in the northeast of England