Laryngeal Cancer in the United States: Changes in Demographics, Patterns of Care, and Survival

Abstract

The decreased survival recorded for patients with laryngeal cancer in the mid-1990s may be related to changes in patterns of management. Future studies are warranted to further evaluate these associations.

Squamous cell carcinoma of the hypopharynx: Single-institution outcome analysis of a large cohort of patients treated with primary non-surgical approaches

“…Despite concerns in the surgical oncology community [19], primary non-surgical therapy keeping surgery reserved for salvage has been widely adopted for advanced laryngeal cancers [12]. However, unlike advanced laryngeal cancers, the question of organ preservation [16,20] has not been subjected to rigorous evaluation in hypopharyngeal cancers, precluding firm conclusions.…”

Erratum

“…Although IMRT can reduce the radiation dose to swallowing structures, 18,19 conceivably leading to improved functional outcomes, optimal larynx preservation seems to also have a formal chemotherapy component. 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).…”

“…[3][4][5][6][7] For example, Hoffman et al, 3 using a robust NCDB, reported that increased use of nonsurgical approaches for larynx preservation was concurrent with decreased relative survival in patients with T3 laryngeal cancers. However, because Hoffman et al 3 culled data from between 1985 and 2001, before the implementation of IMRT and the publication of RTOG 9001 and the more widespread use of induction and concurrent chemotherapy, their findings, although timely when published, do not accurately reflect the use of RT and combined modality techniques in the current era.…”

“…These findings have led some researchers to question the utility of chemoradiation as first-line therapy for T3 laryngeal cancer. [3][4][5][6][7] This is not an invalid concern, as the VA and RTOG trials took place in an era before the introduction of modern RT techniques. The VA 1 and RTOG 2 studies, designed and conducted several decades ago, enrolled patients who were treated with nonvolumetric imaging-based conventional 2D or 3D CRT (2D/3D CRT).…”

“…However, several studies' findings have implied that nonsurgical larynx preservation approaches may be associated with survival decrement. [3][4][5][6][7] Specifically, Hoffman et al, 3 using large-scale series from the National Cancer Data Base (NCDB), reported that the increased use of organ preservation approaches was associated with a decrement in relative survival in patients with T3 laryngeal cancer. Gourin et al, 4 in a retrospective series of locally advanced disease, demonstrated that nonsurgical larynx preservation was associated with poorer survival particularly for patients with T4 disease.…”