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Nonsquamous cell laryngeal cancers: Incidence, demographics, care patterns, and effect of surgery
Author(s) -
Torabi Sina J.,
Cheraghlou Shayan,
Kasle David A.,
Savoca Emily L.,
Judson Benjamin L.
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27785
Subject(s) - medicine , hazard ratio , incidence (geometry) , stage (stratigraphy) , cancer , metastasis , confidence interval , oncology , histology , survival rate , pathology , paleontology , physics , optics , biology
Objectives To analyze the incidence and clinical profile of nonsquamous cell (non‐SCC) laryngeal carcinomas and to analyze the effect of surgery on survival. Study Design A retrospective analysis of the National Cancer Database (2004–2014). Methods Adult patients with non‐SCC laryngeal cancers were divided into six major histological subtypes. A descriptive clinical profile was obtained for non‐SCC patients, and multivariate regressions were performed to analyze the effect of surgery on survival within the non‐SCC cohort. Results We identified 878 cases of non‐SCC laryngeal cancers, representing 1.02% of all malignant laryngeal cancers. Neuroendocrine tumors and bone/cartilage sarcomas made up the largest groups (37.02% and 32.35%, respectively). Metastasis (M) was higher in neuroendocrine tumors, representing 19.1% of those with known clinical M stages. Of those treated, the majority of patients with bone/cartilage sarcomas (80.9%) and minor salivary gland tumors (82.6%) received surgery as part of their treatment. Survival varied significantly based upon histology, with bone/cartilage sarcomas having the highest 5‐year survival at 90.4%, and neuroendocrine tumors exhibiting the poorest 5‐year survival at 25.7%. Multivariate analyses found surgery to be significantly associated with improved survival (hazard ratio: 0.679; 95% confidence interval: 0.472–0.976; P = 0.036). The specific surgical method (i.e., local excision vs. partial vs. total laryngectomy) did not have any effect on survival. Conclusion Approximately 1% of all malignant laryngeal cancers are non‐SCC in origin. At presentation, neuroendocrine tumors have the highest rate of distant metastasis and have the worst prognosis of the non‐SCC cancers. Most non‐SCC patients received surgery as part of their treatment regimen. Level of Evidence NA. Laryngoscope , 129:2496–2505, 2019