Survival analysis of laryngeal squamous cell cancer, considering different treatment modalities and other factors influencing survival – a monocentric retrospective investigation
Gábor Répássy, András Molnár, Stefani Maihoub, Dóra Hargas, Tamás László
Abstract
PURPOSE: This study aimed to investigate the factors affecting laryngeal cancer survival. METHODS: This study retrospectively analysed laryngeal cancer types, treatment options, and potential factors influencing survival. RESULTS: 77 patients (26.27%) had supraglottic laryngeal cancer, 209 (70.13%) had glottic laryngeal cancer, and 7 (3.6%) had subglottic laryngeal cancer. Common comorbidities such as type 2 diabetes mellitus, chronic obstructive pulmonary disease, and coronary disease were observed in 13.65%, 11.9%, and 22.18% of the patients, respectively. Smoking was detected in 88.05% of the patients, while 56.3% reported regular alcohol consumption. The study found that hemilaryngectomy and supraglottic horizontal resection led to significantly longer survival compared to other treatment options (i.e., total laryngectomy, supracricoid horizontal partial laryngectomy, transoral laser cordectomy, chemoradiation, chemotherapy, and radiotherapy), p = 0.000*. Glottic cancers tend to have longer survival when considering laryngeal cancer locations; however, this difference was statistically insignificant (p = 0.640). Statistical comparisons showed significantly longer survival rates for surgical treatments in stages 1 (p = 0.007*) and 4 (p = 0.007*). Factors such as coronary artery disease, higher ECOG performance status, advanced 'N' stages, and higher tumour grades were found to significantly worsen survival, as determined by a Cox proportional hazards model. CONCLUSION: The study revealed that factors such as coronary disease, patients' functionality, 'N' stages, and tumour grade significantly impacted survival rates. Furthermore, the study found that supraglottic horizontal resection and hemilaryngectomy resulted in the longest survival. Surgical methods were associated with significantly longer survival rates in disease stages 1 and 4.