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Treatment, comorbidity and survival in stage III laryngeal cancer
Author(s) -
Connor Katie L.,
Pattle Samuel,
Kerr Gillian R.,
Junor Elizabeth
Publication year - 2015
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23653
Subject(s) - comorbidity , stage (stratigraphy) , cancer survival , medicine , cancer , oncology , biology , paleontology
Background The purpose of this study was for us to identify factors associated with survival and laryngeal function in a contemporary, population‐based study of stage III laryngeal carcinoma. Methods Patients presenting to a tertiary center with stage III laryngeal carcinoma between 1999 and 2010 were included in the study. Kaplan–Meier and Cox proportional hazards analyses were utilized. Results Of 137 patients receiving either surgery ± adjuvant therapy (SURG±Adj = 24.1%), chemoradiotherapy (CRT = 32.8%), or radiotherapy alone (RT = 36.5%), 5‐year cause‐specific survival (5‐year CSS) was 81.0% and 2‐year local relapse rate was 27.5%. RT had higher recurrence ( p < .01), lower 5‐year CSS (90.8% vs 87.8% vs 68.9%/SURG±Adj vs CRT vs RT/ p = .0026) and lower overall survival ( p = .001). Adjusting for excess of severe comorbidity in the RT group, there was no difference in 5‐year CSS between treatment modality. Conclusion SURG±Adj and CRT had similar survival. Severe comorbidity was associated with selection bias to RT and reduced 5‐year CSS. Comorbidity is a key prognostic variable and should be considered in the interpretation of treatment outcomes. © 2014 Wiley Periodicals, Inc. Head Neck 37: 698–706, 2015