The Effect of treatment on survival in patients with advanced laryngeal carcinoma

Abstract

Primary surgical treatment is associated with improved survival for patients with stage IV disease and specifically T4 primary tumors. These data suggest that the observed national decrease in survival from laryngeal cancer may be due to a shift toward nonoperative treatment in that subset of patients with advanced primary disease.

Treatment results, side effects and prognostic factors affecting survival in patients with larynx cancer

“…According to the literature, survival rates for early (stages I and II), and late stage (stages III and IV) larynx cancers range between 73-92% and 35-64%, respectively. [20][21][22] fiengül et al reported that in the 50th month after the onset of therapy, the cumulative survival rate estimated for 172 patients in all disease stages was 69 percent. The cumulative survival rates in various disease stages were as follows: Stage I, 84%; II, 77%; III, 68%, and IV, 56%.…”

Erratum

“…[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.…”

“…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.…”

“…[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. In a retrospective series from the Alberta Cancer Registry, Dziegielewski et al 5 showed that patients with T3 as well as patients with T4a laryngeal cancer had inferior survival for both the radiation alone and the concurrent CRT cohorts compared to the surgical cohorts.…”

“…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).…”