Trends in treatment and survival for advanced laryngeal cancer: A 20‐year population‐based study in The Netherlands

Timmermans, Adriana J.; Dijk, Boukje A. C. van; Overbeek, L.I.H.; Velthuysen, Marie‐Louise F. van; Tinteren, Harm van; Hilgers, Frans J. M.; Brekel, Michiel W. M. van den

doi:10.1002/hed.24200

Cited by 61 publications

(70 citation statements)

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“…Larynx cancer is among the most frequently diagnosed head and neck squamous cell cancers (SCC), and approximately 40% of patients present with advanced disease . The 5‐year overall survival (OS) of the advanced (T3T4) tumors varies between 34% and 49%, depending on patient‐related factors, tumor‐related factors, and treatment . Historically, patients with advanced larynx cancer were treated with a total laryngectomy (TL) with adjuvant radiotherapy (RT).…”

Section: Introductionmentioning

confidence: 99%

Development and external validation of a risk‐prediction model to predict 5‐year overall survival in advanced larynx cancer

et al. 2017

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Objectives/Hypothesis TNM‐classification inadequately estimates patient‐specific overall survival (OS). We aimed to improve this by developing a risk‐prediction model for patients with advanced larynx cancer. Study Design Cohort study. Methods We developed a risk prediction model to estimate the 5‐year OS rate based on a cohort of 3,442 patients with T3T4N0N+M0 larynx cancer. The model was internally validated using bootstrapping samples and externally validated on patient data from five external centers (n = 770). The main outcome was performance of the model as tested by discrimination, calibration, and the ability to distinguish risk groups based on tertiles from the derivation dataset. The model performance was compared to a model based on T and N classification only. Results We included age, gender, T and N classification, and subsite as prognostic variables in the standard model. After external validation, the standard model had a significantly better fit than a model based on T and N classification alone (C statistic, 0.59 vs. 0.55, P < .001). The model was able to distinguish well among three risk groups based on tertiles of the risk score. Adding treatment modality to the model did not decrease the predictive power. As a post hoc analysis, we tested the added value of comorbidity as scored by American Society of Anesthesiologists score in a subsample, which increased the C statistic to 0.68. Conclusions A risk prediction model for patients with advanced larynx cancer, consisting of readily available clinical variables, gives more accurate estimations of the estimated 5‐year survival rate when compared to a model based on T and N classification alone. Level of Evidence 2c. Laryngoscope, 128:1140–1145, 2018

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Section: Introductionmentioning

confidence: 99%

Development and external validation of a risk‐prediction model to predict 5‐year overall survival in advanced larynx cancer

et al. 2017

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“…A study with 5,394 patients with T3 and T4 laryngeal cancer of the SEER tumor registry revealed an increase of the percentage of non-surgically treated patients from 32% to 62% from 1992 to 2009 [134]. An evaluation of 14,000 patients with laryngeal cancer of the Dutch cancer registry confirmed this tendency [135]. The mortality after total laryngectomy amounted to 1.4% in the US in 1997 and 1.1% in 2008 [133].…”

Section: Therapy Of Primarily Diagnosed Laryngeal Cancermentioning

confidence: 99%

“…Patients with T4 laryngeal cancer revealed a significant difference of the 5-year survival rate. After total laryngectomy ± adjuvant radiotherapy it amounted to 48%, after primary radiotherapy to 34%, and after primary radiochemotherapy to 42% [135]. An evaluation of 221 patients with T4 carcinomas performed by Rosenthal et al [142] revealed a significantly better local control after total laryngectomy and postoperative radiotherapy in comparison to larynx preservation protocols.…”

Section: Therapy Of Primarily Diagnosed Laryngeal Cancermentioning

confidence: 99%

Evidence and evidence gaps of laryngeal cancer surgery

Wiegand

2016

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 15:Doc03

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“…In the last decades, concurrent chemoradiotherapy (CRT) or radiotherapy (RT) alone have been shown to be successful in sparing the larynx in the majority of patients while reaching almost similar overall survival (OS) rates . Recent publications, however, demonstrated that in more advanced tumors TL still seems to give the best OS rates . These publications have led to an update in the American Society of Clinical Oncology guidelines in 2018, which now states that extensive (T)3 or large T4a lesions might achieve better survival rates following total laryngectomy .…”

Section: Introductionmentioning

confidence: 99%

Improving decision making in larynx cancer by developing a decision aid: A mixed methods approach

et al. 2019

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ObjectivePatients diagnosed with advanced larynx cancer face a decisional process in which they can choose between radiotherapy, chemoradiotherapy, or a total laryngectomy with adjuvant radiotherapy. Clinicians do not always agree on the best clinical treatment, making the decisional process for patients a complex problem.MethodsGuided by the International Patient Decision Aid (PDA) Standards, we followed three developmental phases for which we held semi‐structured in‐depth interviews with patients and physicians, thinking‐out‐loud sessions, and a study‐specific questionnaire. Audio‐recorded interviews were verbatim transcribed, thematically coded, and analyzed. Phase 1 consisted of an evaluation of the decisional needs and the regular counseling process; phase 2 tested the comprehensibility and usability of the PDA; and phase 3 beta tested the feasibility of the PDA.ResultsPatients and doctors agreed on the need for development of a PDA. Major revisions were conducted after phase 1 to improve the readability and replace the majority of text with video animations. Patients and physicians considered the PDA to be a major improvement to the current counseling process.ConclusionThis study describes the development of a comprehensible and easy‐to‐use online patient decision aid for advanced larynx cancer, which was found satisfactory by patients and physicians (available on http://www.treatmentchoice.info). The outcome of the interviews underscores the need for better patient counseling. The feasibility and satisfaction among newly diagnosed patients as well as doctors will need to be proven. To this end, we started a multicenter trial evaluating the PDA in clinical practice (http://ClinicalTrials.gov Identifier: NCT03292341).Level of EvidenceNA Laryngoscope, 129:2733–2739, 2019

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Trends in treatment and survival for advanced laryngeal cancer: A 20‐year population‐based study in The Netherlands

Cited by 61 publications

References 25 publications

Development and external validation of a risk‐prediction model to predict 5‐year overall survival in advanced larynx cancer

Development and external validation of a risk‐prediction model to predict 5‐year overall survival in advanced larynx cancer

Evidence and evidence gaps of laryngeal cancer surgery

Improving decision making in larynx cancer by developing a decision aid: A mixed methods approach

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