Survival of Patients with Subglottic Squamous Cell Carcinoma

Abstract

Objective Subglottic squamous cell carcinoma is a rare subsite of laryngeal cancer that behaves more aggressively and portends a worse prognosis. Using a population-based cancer registry, our objective was to report overall survival (os) and laryngectomy-free survival (lfs) in patients diagnosed with subglottic squamous cell carcinoma, and to determine whether primary laryngectomy results in improved survival.Methods This retrospective population-based study considered patients with a new diagnosis of squamous cell carcinoma in the province of Ontario over a 15-year period (1995–2009). The Ontario Cancer Registry was examined for patients with the diagnosis of interest during the period of interest. Linked population-based databases were used to obtain patient demographics, comorbidity measures, staging, survival, and primary treatment with laryngectomy.Results Of 4927 patients identified to have laryngeal carcinoma, 89 were defined as having primary subglottic carcinoma (1.8%). In the subglottic cohort, 68 patients were men (76.4%), and mean age at diagnosis was 68 years (interquartile range: 60–77 years). The 5-year os was 47.2%, and the 5-year lfs was 31.5%. In 13 patients (15%), the primary treatment was laryngectomy, which, compared with primary radiation, did not predict for improved os. No differences in os or lfs were observed during the 15-year study period (os p = 0.42, lfs p = 0.83).Conclusions The survival of patients with subglottic carcinoma is poor and has remained stable over time (1995–2009). Compared with primary radiation, primary treatment with laryngectomy does not appear to improve os.

Subglottic squamous cell carcinoma in Denmark 1971–2015 – a national population-based cohort study from DAHANCA, the Danish Head and Neck Cancer group

“…This type of extensive surgery might leave the patients with significant sequelae and hence a deteriorated quality of life despite of longer survival. In contrast, no difference in survival was observed for patients treated with primary laryngectomy compared with patients treated with primary RT [20] in a recently published study by MacNeil et al, including 89 patients in total. These results encourage the recommendation of a laryngeal preservation therapy as an option for primary treatment in suitable patients.…”

“…Other published studies on subglottic SCC presents small, retrospective single institution cohorts (N ¼ 10-89) [10,20] except from one study by Marchiano et al [2] including more than 889 cases extracted from the SEER database. In the study by Marchiano, the primary treatment was RT (34%), surgery (17%), combination of RT and surgery (39%), and no treatment (10%).…”

Surgical management and oncological outcome of non-squamous cell carcinoma of the larynx: a bicentric study

“…The supraglottic and subglottic regions were strongly associated with non-SCC compared to SCC; our cohort was mainly represented by hard and soft tissue sarcomas, histotypes that arise more commonly in these subsites [ 10 , 17 ]. Moreover, the subglottic involvement by SCC is an infrequent event with a range of 1–1.6% worldwide [ 26 , 27 ]. We observed a different distribution of grading between the two groups.…”

Analysis of the TCGA Dataset Reveals that Subsites of Laryngeal Squamous Cell Carcinoma Are Molecularly Distinct

“…LSCC affects three subsites: the supraglottis, glottis and subglottis. The majority of tumors arise in the glottis and supraglottis, while tumors of the subglottis are rare and only comprise 2% of LSCC cases [ 3 , 4 , 5 ]. Tumors in these different sites are associated with distinct symptoms and stages at presentation, rates of nodal metastases, tobacco exposure and survival [ 3 , 4 ].…”

“…The primary subsite also affects the prognosis, with most reports demonstrating that patients with supraglottic LSCC have poorer prognoses compared to those with glottic tumors, while those with subglottic tumors experience an intermediate rate of survival [ 3 , 5 , 7 , 8 ]. Although the anatomical factors described above are likely to play a part in these differences, it is unclear if there are molecular underpinnings that also contribute to clinical outcomes.…”