Factors Predictive of Survival in Advanced Laryngeal Cancer

Abstract

To determine the factors predictive of improved survival among patients with advanced laryngeal cancer.Design: National hospital-based cancer registry.Patients: Patients treated with total laryngectomy (TL), radiation therapy alone (RT), or combined chemotherapy and radiation therapy (chemo-RT).Results: Of the 10 590 patients meeting the initial inclusion criteria, 7019 had appropriate nonmissing values in all study variables and were included in the analysis. Overall, TL was significantly associated with increased likelihood of survival compared with RT or chemo-RT (PϽ.001). Among patients with stage III cancer, TL and chemo-RT had similar impacts on survival (each showed increased survival compared with RT), whereas TL was associated with significantly greater survival than chemo-RT or RT among patients with stage IV disease (PϽ.001). Overall survival was also decreased among men, black patients (compared with white patients), and patients with Medicare or Medicaid or those who were uninsured (compared with those with private insurance).Conclusions: Among patients with the most advanced disease (stage IV), TL was associated with increased survival compared with chemo-RT or RT, whereas both TL and chemo-RT improved survival over RT among patients with stage III cancer. Insurance type and black race also showed significant associations with survival, which may reflect barriers in access to care (PϽ.001).

Disparities in Laryngeal Cancer Treatment and Outcomes: An Analysis by Hospital Safety‐Net Burden

“…In contrast with earlier literature reporting the association of Black patients with lower survival rates in early and advanced laryngeal cancer, [2][3][4] we found that Black patients had similar survival outcomes compared to whites, irrespective of the safety-net status of the treating facility. This discrepancy in our findings is likely due to our study's consideration of additional confounding factors such as treating facility volume, time to start of the first treatment, distance travelled to, and safety-net status of the treating facility.…”

Erratum

“…In both the present study and the study by Hoffman et al, 3 outcomes achieved with RT alone were worse than those achieved with other therapy regimens. In contrary to the results previously reported by Dziegielewski et al 5 and Chen and Halpern, 6 our results showed that the LP-CRT cohort was associated with lower mortality risk compared to the TL-PORT cohort (HR 5 0.74; p 5 .03; Figure 5). …”

Long‐term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas: Improved functional outcomes and survival with modern therapeutic approaches

“…In both the present study and the study by Hoffman et al, outcomes achieved with RT alone were worse than those achieved with other therapy regimens. In contrary to the results previously reported by Dziegielewski et al and Chen and Halpern, our results showed that the LP‐CRT cohort was associated with lower mortality risk compared to the LP‐PORT cohort (HR = 0.74; p = .03; Figure ).…”