Time trends in T3 to T4 laryngeal cancer: a population-based long-term analysis

Head Neck. 2014 Dec;36(12):1727-31. doi: 10.1002/hed.23524. Epub 2014 Jan 29.

Abstract

Background: A decline in laryngectomies and survival in laryngeal cancer has been reported, especially among patients with advanced tumors.

Methods: Of 1058 patients with laryngeal cancer diagnosed from 1978 to 2007 in the Uppsala-Örebro region in Sweden, 263 T3 to T4 tumors treated with curative intent were studied retrospectively. Two time periods were defined, 1978 to 1992 and 1993 to 2007.

Results: Glottic tumors decreased constituting 68.6% of cases in 1978 to 1992 and 47.9% in 1993 to 2007. Laryngectomies were performed in 38.8% and 34.5% in the corresponding time periods. The use of laryngectomy was not strongly prognostic. A decline in overall survival (OS) over time could only be identified for the first year of follow-up. Chemotherapy was only used in a minority of cases.

Conclusion: The marked decrease of glottic site may mark a shift in etiology. Laryngectomy was not strongly associated with improved survival. The absence of improved survival calls for intensified research.

Keywords: cancer; glottic; laryngeal; laryngectomy; supraglottic.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Combined Modality Therapy
  • Female
  • Glottis
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / diagnosis
  • Laryngeal Neoplasms / mortality*
  • Laryngeal Neoplasms / therapy*
  • Laryngectomy
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Sweden
  • Time Factors

Substances

  • Antineoplastic Agents