Abstract
A cohort study was undertaken to analyze the risk of recurrence among 1616 patients with primary squamous cell carcinoma of the larynx from 1983 to 2010 at a single, tertiary academic center in Oslo, Norway. The cohort was followed from the date of diagnosis to September 2011. Competing risk regression analysis assessed the association between various risk factors and the risk of recurrence, where death was considered a competing event. Recurrence was observed in 368 patients (23%) during the study period. The majority (71%) of recurrences involved the location of the primary tumor. The overall risk of recurrence during the first three years after initiating treatment was 20.5%. Increased risk of recurrence was observed in patients with supraglottic cancer, younger patients, those with T2–T3 tumors and in patients treated in the earlier part of the study period. Significant factors for recurrence in glottic carcinomas were age, treatment in the earlier part of the study and T-status, whereas age was a significant factor in supraglottic cancer. N-status appeared less significant. In conclusion, follow-up of laryngeal squamous cell carcinoma should place particular emphasis on the site of the primary tumor, younger patients, cases of supraglottic cancer and T2-T4 primary tumors, especially during the first three years after treatment. More studies are needed to assess the impact of surgical versus non-surgical treatment, and eventually the significance of recurrence, for disease-specific and overall survival in cases of advanced laryngeal squamous cell carcinoma.
Highlights
Laryngeal squamous cell carcinoma (LSCC) accounts for approximately 17% of all primary head and neck cancers (HNSCC) in Norway, with an age-standardized incidence rate (ASR) for laryngeal cancer of 1.4 per 100,000 in 2014 [1]
1616 patients were diagnosed with primary LSCC during the study period
This study of 1615 LSCC patients represents approximately 60% of all patients diagnosed with LSCC in Norway between 1983 and 2010
Summary
Laryngeal squamous cell carcinoma (LSCC) accounts for approximately 17% of all primary head and neck cancers (HNSCC) in Norway, with an age-standardized incidence rate (ASR) for laryngeal cancer of 1.4 per 100,000 in 2014 [1]. Males with glottic cancer predominate, but during the last three decades the proportion of females has increased significantly [2]. The treatment of early and advanced stage laryngeal cancer has been subject to a substantial development during the last three decades. The objective of LSCC management is cure with preserved laryngeal function. It is vital to assess the risk of recurrent disease in each case. The risk of recurrence varies considerably with the modality of treatment, as with subsite, N-status and T-status [3, 4]. Stage laryngeal cancer is generally associated with
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