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Survival Analysis in Patients with Laryngeal Cancer: A Retrospective Cohort Study

Introduction: The worldwide incidence rate of laryngeal cancer is declining. However, the 5-year survival for these patients has decreased in recent years from 66% to 63%. This may be due to changes in the treatment of the disease. The present study aimed to evaluate the survival rate of patients wi...

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Autores principales: Molina-Fernández, Elena, Palacios-García, José M., Moreno-Luna, Ramón, Herrero-Salado, Tomás, Ventura-Díaz, Julio, Sánchez-Gómez, Serafín, Vilches-Arenas, Ángel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965107/
https://www.ncbi.nlm.nih.gov/pubmed/36836648
http://dx.doi.org/10.3390/life13020295
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author Molina-Fernández, Elena
Palacios-García, José M.
Moreno-Luna, Ramón
Herrero-Salado, Tomás
Ventura-Díaz, Julio
Sánchez-Gómez, Serafín
Vilches-Arenas, Ángel
author_facet Molina-Fernández, Elena
Palacios-García, José M.
Moreno-Luna, Ramón
Herrero-Salado, Tomás
Ventura-Díaz, Julio
Sánchez-Gómez, Serafín
Vilches-Arenas, Ángel
author_sort Molina-Fernández, Elena
collection PubMed
description Introduction: The worldwide incidence rate of laryngeal cancer is declining. However, the 5-year survival for these patients has decreased in recent years from 66% to 63%. This may be due to changes in the treatment of the disease. The present study aimed to evaluate the survival rate of patients with LC according to the stage of the disease and the treatment applied. For this purpose, surgical versus organ preservation protocols (OPP) based on chemoradiotherapy were evaluated. Methods: A retrospective cohort study was conducted in a tertiary hospital. The study included adult patients with a clinical diagnosis of primary LC. Patients with LC and systemic metastases and those with synchronous tumors at diagnosis were excluded. Univariate and multivariate analyses were performed to determine the association between exposure to LC treatment and the time to event (death). Overall survival (OS), cause-specific survival (CSS), and disease-free survival (DFS) were calculated. Results: Patients with advanced tumors (stages III and IV) had almost three times the risk of LC death than those in the initial tumor stages (I and II) [HR CCS = 2.89 (95%CI 1.30–6.39)]; [HR OS = 2.01 (95%CI 1.35–2.98)]. Patients who underwent surgical treatment had a higher chance of survival than those who were treated according to OPP [HR = 0.62; 95%CI (0.38–1.02)] in CSS, 0.74 [95%CI (0.50–1.90)] in OS, and 0.61 [95%CI (0.40–0.91)] in DFS. Discussion: OPP changed the management of patients with advanced stages of LC, establishing CRT as an alternative to surgery. Our data did not reveal clinically relevant differences in OS between patients treated with OPP and those who underwent surgery; however, we reported differences in the DFS rate after five years of follow-up in favor of the surgery-treated group of patients. Conclusion: Surgical treatment improves CSS and DFS at five years in patients with initial LC with respect to radiation therapy alone. Furthermore, surgical treatment associated with complementary radiation therapy offers better CSS and DFS in patients with advanced LC.
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spelling pubmed-99651072023-02-26 Survival Analysis in Patients with Laryngeal Cancer: A Retrospective Cohort Study Molina-Fernández, Elena Palacios-García, José M. Moreno-Luna, Ramón Herrero-Salado, Tomás Ventura-Díaz, Julio Sánchez-Gómez, Serafín Vilches-Arenas, Ángel Life (Basel) Article Introduction: The worldwide incidence rate of laryngeal cancer is declining. However, the 5-year survival for these patients has decreased in recent years from 66% to 63%. This may be due to changes in the treatment of the disease. The present study aimed to evaluate the survival rate of patients with LC according to the stage of the disease and the treatment applied. For this purpose, surgical versus organ preservation protocols (OPP) based on chemoradiotherapy were evaluated. Methods: A retrospective cohort study was conducted in a tertiary hospital. The study included adult patients with a clinical diagnosis of primary LC. Patients with LC and systemic metastases and those with synchronous tumors at diagnosis were excluded. Univariate and multivariate analyses were performed to determine the association between exposure to LC treatment and the time to event (death). Overall survival (OS), cause-specific survival (CSS), and disease-free survival (DFS) were calculated. Results: Patients with advanced tumors (stages III and IV) had almost three times the risk of LC death than those in the initial tumor stages (I and II) [HR CCS = 2.89 (95%CI 1.30–6.39)]; [HR OS = 2.01 (95%CI 1.35–2.98)]. Patients who underwent surgical treatment had a higher chance of survival than those who were treated according to OPP [HR = 0.62; 95%CI (0.38–1.02)] in CSS, 0.74 [95%CI (0.50–1.90)] in OS, and 0.61 [95%CI (0.40–0.91)] in DFS. Discussion: OPP changed the management of patients with advanced stages of LC, establishing CRT as an alternative to surgery. Our data did not reveal clinically relevant differences in OS between patients treated with OPP and those who underwent surgery; however, we reported differences in the DFS rate after five years of follow-up in favor of the surgery-treated group of patients. Conclusion: Surgical treatment improves CSS and DFS at five years in patients with initial LC with respect to radiation therapy alone. Furthermore, surgical treatment associated with complementary radiation therapy offers better CSS and DFS in patients with advanced LC. MDPI 2023-01-20 /pmc/articles/PMC9965107/ /pubmed/36836648 http://dx.doi.org/10.3390/life13020295 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Molina-Fernández, Elena
Palacios-García, José M.
Moreno-Luna, Ramón
Herrero-Salado, Tomás
Ventura-Díaz, Julio
Sánchez-Gómez, Serafín
Vilches-Arenas, Ángel
Survival Analysis in Patients with Laryngeal Cancer: A Retrospective Cohort Study
title Survival Analysis in Patients with Laryngeal Cancer: A Retrospective Cohort Study
title_full Survival Analysis in Patients with Laryngeal Cancer: A Retrospective Cohort Study
title_fullStr Survival Analysis in Patients with Laryngeal Cancer: A Retrospective Cohort Study
title_full_unstemmed Survival Analysis in Patients with Laryngeal Cancer: A Retrospective Cohort Study
title_short Survival Analysis in Patients with Laryngeal Cancer: A Retrospective Cohort Study
title_sort survival analysis in patients with laryngeal cancer: a retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965107/
https://www.ncbi.nlm.nih.gov/pubmed/36836648
http://dx.doi.org/10.3390/life13020295
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