Salvage Surgery following Radiation Failure for Laryngeal Cancer in Elderly Patients

Abstract

Objective. To find the survival rate of patients ≥80 years old who undergo salvage surgery for squamous cell carcinoma of the larynx. Study Design. National data registry analysis. Setting. Seventeen population-based registries comprising the National Cancer Institute’s Surveillance, Epidemiology, and End Results database. Subjects and Methods. Overall, cancer-specific, and relative survival rates were calculated from 1418 patients, stratified into 3 age cohorts, who underwent surgery following radiation therapy for treatment of laryngeal cancer. Results. The 1-year overall survival of patients ≥80 years old (n = 57) was 76.1%. The cancer-specific survival at 1 year was 86.4%. These survival rates were significantly less than those of patients <65 years old (n = 869), who had a 1-year overall survival of 88.1% ( P = .006) and cancer-specific survival of 90.5% ( P = .029). Patients aged between 65 and 79 years old (n = 492) displayed 1-year overall survival of 80.7% ( P = .426) and cancer-specific survival of 85.1% ( P = .711), which were not significantly different from the ≥80 year cohort. When comparing relative survival at 5 years, the ≥80-year-old cohort’s survival trended the highest (≥80 years, 62.8%; 65-79 years, 51.3%; 20-64 years, 56.2%). Conclusion. While patients ≥80 years old have a less favorable prognosis than patients <65 years old, the survival rates of patients ≥80 years old are not significantly different from the 65- to 79-year-old cohort. After controlling for non-cancer-related death, patients ≥80 years old appear to have similar 5-year survival outcomes compared with other patients.