Survival Outcomes in Patients with T2N0M0 (Stage II) Squamous Cell Carcinoma of the Larynx

Author:

Gainor Danielle L.1,Marchiano Emily1,Bellile Emily2,Spector Matthew E.1,Taylor Jeremy M. G.2,Wolf Gregory T.1,Hogikyan Norman D.1,Prince Mark E.1,Bradford Carol R.1,Eisbruch Avraham3,Worden Francis4,Shuman Andrew G.1

Affiliation:

1. Department of Otolaryngology–Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA

2. Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA

3. Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, Michigan, USA

4. Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA

Abstract

Objective Emerging data have demonstrated suboptimal outcomes among patients with stage II larynx cancer. Our objective is to report survival outcomes for T2N0M0 larynx cancer and to determine the cause-specific survival. Study Design Case series with planned data collection. Setting Tertiary academic center. Subjects Adults with T2N0M0 squamous cell carcinoma of the larynx treated with curative intent. Methods A head and neck cancer epidemiology database was queried for eligible subjects from 2003 to 2014. Data were extracted from the electronic medical record and research database, and survival analyses were performed. Results Thirty-four patients with previously untreated stage II larynx cancer were identified (median follow-up 48 months). Patients included 27 males and 7 females with a mean age of 59 years. The majority of tumors arose from the glottis (59%). Of the cohort, 12% were treated with surgery, 65% radiation therapy, and 24% chemoradiation therapy. The estimated 2-year overall survival was 81%, (95% confidence interval [CI], 59%-92%), disease-specific survival was 91% (95% CI, 69%-98%), and recurrence-free survival was 84% (95% CI, 65%-93%). Four of 5 patients with persistent or recurrent disease posttreatment were successfully salvaged with total laryngectomy with 100% locoregional control. There were 11 mortalities (2 disease related, 2 due to metachronous primaries, 3 treatment related, and 4 from other/unknown causes). Conclusion Stage II laryngeal cancer has suboptimal survival outcomes. This appears to be a reflection of medical comorbidities, propensity for metachronous primaries, and the sequelae of late treatment effects rather than poor locoregional control.

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Surgery

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