1031 Survival Outcomes for Larynx-Preserving Therapy Compared to Total Laryngectomy in Advanced Laryngeal Tumour: A North-East of Scotland Cohort

Abstract

Abstract Aim Advanced laryngeal tumours (stage III and IV) management remains uncertain. This study aims to investigate whether choice of organ-preservation treatment (radiotherapy or radiochemotherapy) or surgical intervention (total laryngectomy with/without adjuvant therapy) affects survival in the North-east of Scotland cohort. Method Laryngeal cancer data was prospectively collected and maintained at a tertiary care centre at NHS Grampian Scotland. This data was retrospectively analysed for overall and disease specific survival. Death from laryngeal cancer was recorded from death certificates. Statistical analysis with Cox regression was used to estimate hazard ratios for sex, smoking status, age, staging, tumour site, and treatment choice in the advanced laryngeal cancer cohort. Results A total of 311 laryngeal cancer patients were identified. 49 patients were stage III and of which 35 (71%) received organ-preserving treatment and 14(29%) underwent total laryngectomy. The corresponding numbers for 65 stage IV patients were 13 (20%) and 52 (80%) respectively. On cox regression for overall survival, reduced survival was associated (p<0.05) with choice of organ preservation and stage IV disease, fully adjusted HRs (95%CI) were 2.57 (1.42–4.66) and 3.00(1.08–8.34) respectively. For disease specific survival, no variables were found to be significant. Median follow up time from date of diagnosis to death was 1.56 years. Conclusions Organ preserving intervention was associated with a worsened overall survival in the advanced laryngeal cancer cohort. This study suggests that primary surgical intervention remains a key element in the treatment of advanced laryngeal cancer and future bigger cohort studies may be needed to evaluate this relationship.