Locally advanced laryngeal cancer: parsing the data on optimal approach

  • Patel SA & al.
  • Cancer
  • 17 Jun 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • The relative benefits of partial laryngectomy (PL), total laryngectomy (TL), and primary chemoradiotherapy (CRT) vary by T stage and nodal burden in patients with stage III/IV laryngeal squamous cell carcinoma (SCC).

Why this matters

  • The optimal treatment modalities for laryngeal SCC remain controversial, particularly regarding larynx-preserving strategies vs surgery.

Key results

  • Overall, CRT was associated with similar survival to PL (aHR, 1.02; P=.750) and TL (aHR, 0.97; P=.412).
    • In stratified analysis, TL followed by adjuvant RT/CRT was associated with improved survival vs definitive CRT (aHR, 0.88; P=.016).
  • In patients with non-T4, low-nodal-burden (T2N1 or T3N0-N1) disease, CRT was associated with similar survival to PL (aHR, 0.87; P=.111) and TL (aHR, 1.02; P=.775).
  • In patients with non-T4, high-nodal-burden (T2-T3N2-N3) disease, TL was associated with worse survival than CRT (aHR, 1.25; P=.016).
  • In patients with T4N0-N3 disease, TL was associated with better survival than CRT (aHR, 0.80; P=.002).

Study design

  • 8703 patients with stage III/IV laryngeal SCC from the National Cancer Database were analyzed for associations between treatment modality and survival outcomes.
  • Funding: None disclosed.

Limitations

  • Retrospective study of large database.