Abstract
Recent reports suggest a decline over time in the survival of patients newly diagnosed with laryngeal cancer in spite of developments in treatment practices. Our study set out to determine whether the survival of patients with laryngeal cancer in Ontario has changed over time. This population-based cohort study of patients diagnosed with laryngeal cancer in the province of Ontario between 1995 and 2007 used data extracted from linked provincial administrative and registry databases. Its main outcomes were overall survival, laryngectomy-free survival, and survival ratio relative to an age- and sex-matched general population. The 4298 patients newly diagnosed with laryngeal cancer during the period of interest were predominantly men (n = 3615, 84.1%) with glottic cancer (n = 2787, 64.8%); mean age in the group was 66 years (interquartile range: 59-74 years). Patient demographics did not significantly change over time. Overall, 5-year survival was 57.4%; laryngectomy-free survival was 45.4%. Comparing patients from three eras (1995-1998, 1999-2003, 2004-2007) and adjusting for age, sex, and comorbidity status, we observed no differences in overall survival or laryngectomy-free survival over time. The 5-year relative survival ratio for patients with laryngeal cancer compared with an age- and sex-matched group from the general population was 81.1% for glottic cancer and 44.5% for supraglottic cancer. In patients with a new diagnosis of laryngeal cancer, overall and laryngectomy-free survival have remained unchanged since the mid-1990s. New methods to improve survival and the rate of laryngeal preservation in this patient population are needed.
Highlights
In Canada in the year 2013, 1050 new cases of laryngeal cancer and 390 deaths attributable to that cancer were reported1
In patients with a new diagnosis of laryngeal cancer, overall and laryngectomy-free survival have remained unchanged since the mid-1990s
E85 Current Oncology—Volume 22, Number 2, April 2015 compared with radiation alone, chemoradiation was later confirmed in a meta-analysis to achieve higher overall survival for patients with advanced laryngeal cancer14
Summary
In Canada in the year 2013, 1050 new cases of laryngeal cancer and 390 deaths attributable to that cancer were reported. For early-stage laryngeal cancers, the treatment options include radiation and partial surgical excision of the larynx. A Cochrane systematic review of treatment in early laryngeal cancer demonstrated no difference in survival for surgical excision compared with radiation. A landmark randomized controlled trial demonstrated no difference in overall survival for laryngectomy compared with chemoradiation, with higher laryngeal preservation rates in the chemoradiation group. E85 Current Oncology—Volume 22, Number 2, April 2015 compared with radiation alone, chemoradiation was later confirmed in a meta-analysis to achieve higher overall survival for patients with advanced laryngeal cancer. Chemoradiation became an alternative to laryngectomy for advanced laryngeal cancer, achieving higher laryngectomy-free survival. Recent reports suggest a decline over time in the survival of patients newly diagnosed with laryngeal cancer in spite of developments in treatment practices. Our study set out to determine whether the survival of patients with laryngeal cancer in Ontario has changed over time
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