Role of Clinical-Demographic Data in Survival Rates of Advanced Laryngeal Cancer

Abstract

Background and Objectives: Laryngeal cancer is one of the most common cancers in the upper aerodigestive tract, and tobacco and alcohol habits are the most relevant risk factors. The role of these risk factors in the incidence of laryngeal carcinomas is well known, yet only a few studies have been conducted on their role as risk factors of prognosis. The aim of the study was to assess the impact of clinical–demographic data on overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) in patients with advanced-stage laryngeal cancer (Stage III–IV) who underwent total laryngectomy. Materials and Methods: This retrospective study was carried out on patients with Stage III–IV laryngeal squamous cell carcinoma treated with total laryngectomy between 2004 and 2014. For each patient, clinical and anamnestic data were collected and collated in a database, including alcohol and smoking habits. Results: Considering the variable age, family history, alcohol, grading, subsite, stage, pT stage, pN stage, and adjuvant therapy, no statistical significance was found for five-year OS. Smoking was the only variable that was statistically significant (p = 0.0043). A relevant difference was noted in the five-year DFS between pN-negative and pN-positive tumors (74.3% vs. 55.26%, respectively; p = 0.056), and a statistically significant difference was found between non- and ≤20 cigarettes/day smokers and heavy smokers (77.78% vs. 53.66%, respectively; p = 0.021). The five-year disease-specific survival rate was 68.83%, and a significant difference was detected for the smoking and pN stage variables. Heavy smokers (43.90% died vs. 16.67% of the non- and ≤20 cigarettes/day smokers; p = 0.0057) and pN-positive (42.1% died vs. 20.51% of the pN-negative patients; p = 0.042) patients had a worse prognosis. Conclusion: Smoking in our study was found to be an important independent risk factor for worse OS and DSS in patients with advanced laryngeal cancer.

Factors Associated With a Prolonged Diagnosis‐to‐Treatment Interval in Laryngeal Squamous Cell Carcinoma

“…Also, data on current smoking status are unavailable in the current NCDB Data Dictionary. This is a major limitation as smoking status has been linked to patient survival in previous studies 64 . We applied multiple exclusion criteria in our cohort, which limited our patient base by more than a half yet still left a large cohort for analysis.…”

CD44, PDL1, and ATG7 Expression in Laryngeal Squamous Cell Carcinomas with Tissue Microarray (TMA) Technique: Evaluation of the Potential Prognostic and Predictive Roles

“…The purpose of this surgery is to avoid highly mutilating total laryngectomy [4] and, with respect to oncological radicality, to maintain laryngeal function [5]. At the time of diagnosis, most LSCC patients present with an advanced stage of the disease for which total laryngectomy is required in treatment [6]. Regarding patient quality of life, total laryngectomy has important psychophysical and social consequences due to functional changes in vocalization resulting from the removal of the larynx, leading to an immediate loss of phonatory function [7] and permanent separation of the upper from the lower airways for which a tracheostomy is required to allow patients to breathe [8].…”