Cases Of Laryngeal Cancer Research Articles

Correlation of laryngeal squamous cell carcinoma and infections with either HHV-8 or HPV-16/18

Each year more than 159,000 new cases of laryngeal cancer are diagnosed globally, and more than 9000 patients die due to this malignancy. Viral infections are a known risk factor for this malignancy. Thus, this study aimed to evaluate the role of HPV-16/18 and HHV-8 infection in patients with laryngeal cancer.In this case–control study, 60 formalin-fixed, paraffin-embedded samples of laryngeal cancer and 22 normal larynx tissue samples from the Pathology Department of Qaem Hospital, Mashhad, Iran were studied. After validating the diagnosis, the samples were evaluated for the detection of HPV-16/18 and HHV-8 DNA using PCR technique. The data were registered and analyzed using SPSS 18.0.The average age for patients and controls was 61.29±11.89 and 55.77±10.10, respectively. Fifty-four patients (90%) and 16 (72.7%) controls were male. PCR results detected no HPV-16/18 DNA in both groups. Although there were 2 positive HHV-8 samples in both laryngeal cancer and normal larynx samples, no significant relation was present (p=0.291).We found no significant relationship between infection with HHV-8 or HPV-16/18 and the existence of laryngeal cancer. However, more complementary studies are required to re-evaluate our results using more samples and better viral detection techniques.

Laryngeal Cancer in Kazakhstan - Ethnic, Age and Gender Differences over Time

The purpose of the present study was to provide an assessment of the incidence of cancer of the larynx in Kazakhstan with especial attention to ethnicity and gender, as well as age. The retrospective design covered all new cases of laryngeal cancer in 11 years (1999-2009). The total number was 4,967 cases, 4,535 (91.3%) in males and 432 (8.7%) in women, with a gender ratio of 10.5:1. Patients of Kazakh (31.2%) and Russian (51.4%) ethnicity accounted for the vast majority (82.6%), with Russians predominating in both sexes, but particularly in females. Age peak in Kazakhs was 70 years and older (14.6 ± 0.70/0000), and in Russians was 60-69 years (21.6 ± 1.30/0000). In the dynamics, the rates had the tendency to decrease more markedly in Russian than Kazakh men, especially in the younger groups, while increase was noted in the youngest females of both ethnicities, but again greater in Russians, presumably reflecting change in underlying lifestyle factors.

Surgical treatment of advanced laryngeal cancer with preservation of laryngeal function

To explore the surgical methods for advanced laryngeal cancer and long term effects of laryngectomy. Two hundred and thirty-eight cases of laryngeal cancer at different stages, including 103 cases with supraglottic cancer, 118 cases with glottic cancer, 3 cases with subglottic cancer, and 14 cases with recurrent cancer, underwent different kinds of operation from 2000 to 2010. The TNM classifications were as follows: T3 168 cases, T4 70 cases. Stage III 145 cases, Stage IV 93 cases. N0 134 cases,N1 64 cases,N2 38 cases, and N3 2 cases. The effects of operation, especially with the preservation of laryngeal function, was analyzed. The disease-free survival rate was calculated by Kaplan-Meier methods. Partial laryngectomy was performed on 142 of the 238 cases (59.7%). Total laryngectomy was performed on 96 cases. In 142 patients who received partial laryngectomy with preservation of laryngeal function, the trachea cannula was extracted in 90 patients, with the decannulation rate as 63.4%. The nasal feeding tube was removed and peroral feeding was recovered in all patients. The patients undergoing partial laryngectomy succeeded in phonation. The 3 years and 5 years disease-free survival rates in all patients were 81.4% and 59.5%. The 3 years and 5 years disease-free survival rate of partial laryngectomy were 82.9% and 64.3%. The 3 years and 5 years disease-free survival rates in total laryngectomy were 79.2% and 52.4%. There was no significantly different between the two groups (χ(2) = 2.478, P = 0.115). For the advanced laryngeal cancer, it is possible to preserve the laryngeal function without compromising the remote survival rate by detailed pre-operational estimation, properly selected operation and skilled surgical practice.

102 Occupational asbestos exposure and risk of pleural mesothelioma, lung and laryngeal cancer in the prospective Netherlands Cohort Study

ObjectivesAlthough asbestos research has been ongoing for decades, there are remaining questions regarding cancer risk associated with low exposure and cancer subtypes, the influence of potential confounders, and the interaction...

Epidemiological Evaluation of Laryngeal Cancer Incidence in Kazakhstan for The Years 1999-2009

The purpose was to provide a descriptive epidemiological assessment of the incidence of cancer of the larynx in Kazakhstan and spatial evaluation with gender characteristics. This retrospective study covered all new cases of laryngeal cancer in 11 years (1999-2009). The total number was 4,967 cases, 4,535 (91.3%) in males and 432 (8.7%) in women, with a ratio of 10.5:1. The higher incidence in men compared to women was evident in all age groups, the differences being statistically significant (p<0.05). At the same time revealed a unimodal growth with age, peaking at 70 years and older both sexes. In the dynamics, incidence rates of laryngeal cancer demonstrated a tendency to decrease, in women (T=-6.7%) this being more pronounced than in men (T=-3.3%). Levels were determined to produce cartograms of cancer of the larynx for male and female populations, clear geographical variation being evidenced. The data are discussed with reference to possible risk factors.

Analiza kliniczno-epidemiologiczna wyników leczenia chorych z rakiem krtani w Oddziale Otolaryngologicznym Wojewódzkiego Szpitala Specjalistycznego w Rzeszowie w latach 1996–2005

Cancer of the larynx is an important epidemiological and oncological problem.According to the National Cancer Registry, 2075 new cases of laryngeal cancer were recorded in 2008 in Poland, which accounts for approximately 50% of malignant head and neck tumours.The modality of treatment and prognosis depend on the primary location of the tumour and the advancement of the symptoms. The main objective of the study was to evaluate the treatment results among patients with laryngeal cancer who were treated surgically and in combination with radiotherapy in the Departments of Otolaryngology and Radiotherapy at the Voivodal Specialist Hospital in Rzeszów between 1996 and 2005.The detailed objectives are 1) impact assessment of selected epidemiological factors on clinical outcomes and prognosis; 2) the risk of locoregional recurrence, depending on the chosen clinical and histopathological features.The clinical material consists of 359 patients diagnosed with laryngeal cancer and treated at the Otolaryngology Department of Voivodal Specialist Hospital in Rzeszow, Poland between 1996 and 2005. ConclusionsThe results of surgical treatment of patients with laryngeal cancer treated between 1996 and 2005 are comparable with the data which are published at present: 5-year survival of 58.5% and 10-year survival of 38.5% of in the examined group of patients.1.Gender and the habit of smoking were not factors affecting the survival rate after the surgery.2.Lower degree of cancer differentiation reduces significantly the probability of survival and shortens the period of survival after the surgery.3.Histological type of cancer does not affect the survival period, probability of survival and the proportion of surviving patients.4.The percentage of those surviving and the probability of survival among patients treated surgically for laryngeal cancer in clinical stage I is significantly higher than compared with clinical stage II, III and IV.

A Low Selenium Level Is Associated with Lung and Laryngeal Cancers

PurposeIt has been suggested that selenium deficiency is a risk factor for several cancer types. We conducted a case-control study in Szczecin, a region of northwestern Poland, on 95 cases of lung cancer, 113 cases of laryngeal cancer and corresponding healthy controls.MethodsWe measured the serum level of selenium and established genotypes for four variants in four selenoprotein genes (GPX1, GPX4, TXNRD2 and SEP15). Selenium levels in the cases were measured after diagnosis but before treatment. We calculated the odds of being diagnosed with lung or laryngeal cancer, conditional on selenium level and genotype.ResultsAmong lung cancer cases, the mean selenium level was 63.2 µg/l, compared to a mean level of 74.6 µg/l for their matched controls (p<0.0001). Among laryngeal cancer cases, the mean selenium level was 64.8 µg/l, compared to a mean level of 77.1 µg/l for their matched controls (p<0.0001). Compared to a serum selenium value below 60 µg/l, a selenium level above 80 µg/l was associated with an odds ratio of 0.10 (95% CI 0.03 to 0.34; p = 0.0002) for lung cancer and 0.23 (95% CI 0. 09 to 0.56; p = 0.001) for laryngeal cancer. In analysis of four selenoprotein genes we found a modest evidence of association of genetic variant in GPX1 with the risk of lung and laryngeal cancers.ConclusionA selenium level below 60 µg/l is associated with a high risk of both lung and laryngeal cancer.

Protection against laryngeal and pharyngeal carcinoma: Heterozygous vs. homozygous deletions of GSTM1 and GSTT1

Deletions in GSTM1 and GSTT1 genes are considered to be a risk factor for cancer development but the exact location of these deletions in the genome was unknown. Three main objectives of the current study were to: (a) identify the boundaries of these deletions in the human genome, (b) screen homozygous (−/−) and heterozygous (+/−) deleted, as well as homozygous present (+/+) individuals using PCR assays, (c) detect associations of pharyngeal (PC) and laryngeal cancer (LC) with the respective genotypes. In total, 102 PC and 92 LC patients were screened and compared with 150 controls. PCR mapping and sequencing revealed a 6 kbp deletion for GSTM1 and a 9 kbp deletion for the GSTT1 gene. The mean age of PC cases was 48.1 (±16.7) years; for LC cases it was 48.5 (±17.4) years and for controls 46 (±17.7) years. The OR (odds ratio) for the GSTM1 null genotype in PC and LC cases was 10.2 and 1.0 (95% CI 5.04–20.7 and 1.1–1.7) respectively. Similarly, for GSTT1 the OR was 4.02 with a 95% CI of 2.3–7.1 in PC cases. For LC cases the OR was 0.8 with 95% CI of 0.4–1.7. A non-significant number of LC and PC patients had heterozygous deletions of GSTM1 compared to controls (OD 0.5, 95% CI 0.2– 1.6 and OR 0.5, 95% CI 0.2– 1.5 respectively). The GSTT1 gene also showed a non-significant association in PC (OD 0.9, 95% CI 0.4–1.9), as well as in LC patients (OD 0.7, 95% CI 0.3–1.7). The homozygous genotype was significantly associated with PC and LC, whereas the heterozygous was not so. The GSTM1 (−/−) and GSTT1 (−/−) genotypes are a risk factor for LC and PC, whereas the (+/−) genotypes are not.

Cytochrome P450 1A1 and Glutathione S-Transferase Pi 1 Mutations in Pharyngeal and Laryngeal Carcinoma

In the current case control study, 94 pharyngeal, 67 laryngeal cancer cases and 150 cancer free controls were screened via PCR-SSCP assay. Mean ages of pharyngeal, laryngeal cancer patients and control was 48.14 (± 16.7), 48.56 (± 17.4) and 46 (± 17.69) years respectively. Results revealed two novel mutations in CYP1A1 gene, a substitution mutation of A2842C resulting in missense tyrosine to serine formation and frameshift mutation due to insertion of thymidine at nucleotide 2842 resulting in 495 nucleotide sequences to alter. It was found that 3.2% pharyngeal and 2.98% laryngeal cancer patients had these mutations in CYP1A1. In GSTP1 gene exon 7, an A2848T substitution causes a leucine to leucine formation whereas G2849A substitution causes alanine to threonine formation at amino acid 166 and 167 respectively. These exonic mutations were found in 7.4% pharyngeal cancer and 9% laryngeal cancer patients. Two intronic deletions of C at nucleotide 1074 and 1466 were found in 1% pharyngeal and laryngeal cancer patients. Accumulation of mutations in CYP1A1 and GSTP1 genes seem to be associated with increased risk of pharyngeal and laryngeal cancer development.

Microelements as risk factors for cancer of the lung and larynx

Selenium deficiency has been suggested by several studies to be associated with cancer risk. We conducted a case-control study in Szczecin, a region of northwestern Poland, on 86 cases of lung cancer, 87 cases of laryngeal cancer and an equal number of healthy controls. We studied the serum level of selenium and genotypes for four variants in four selenoprotein genes (GPX1, GPX4, TXNRD2 and SEP15) and the odds of being diagnosed with lung or laryngeal cancer. Among lung cancer cases, the mean selenium level was 63.2 µg/l, compared to a mean level of 74.7 µg/l for their matched controls (p 80 µg/l) was associated with an odds ratio of 0.10 (95% CI 0.03 to 0.34; p = 0.0002) for lung cancer and 0.24 (95% CI 0.10 to 0.59; p = 0.002) for laryngeal cancer. In four selenoproteins studied here we found a modest associations of genetic variants in GPX1 and GPX4 with lung and TXNRD2 with laryngeal cancer risk. We analyzed iron (Fe) level in serum of 77 lung cancer patients and 77 matched controls. We did not find difference in mean Fe level between cases and controls (1053.05 µg/l and 1059.39 µg/l). However, we found that Fe level in the lowest and highest quartiles was associated with a significant lung risk enhancement when compared to a serum Fe level in the middle quartiles (OR 0.3, p 0.02). We also observed that the relationship between the level of Fe and Se could be an important factor for lung cancer risk.

Quantitative assessment of the association between GSTM1 null genotype and laryngeal cancer risk

Previous studies investigating the association between glutathione S-transferase M1 (GSTM1) null genotype and laryngeal cancer risk reported controversial results. Thus, a meta-analysis was performed to clarify the effect of GSTM1 null genotype on laryngeal cancer risk. A literature search was performed for all possible studies. We estimated summary odd ratio (OR) with its 95 % confidence interval (95 % CI) to assess the association. Subgroup analyses were performed by ethnicity or the sample size. 24 individual case-control studies involving a total of 2,809 laryngeal cancer cases and 4,478 controls were finally included into this meta-analysis. Meta-analyses of total 24 studies showed the GSTM1 null genotype was significantly associated with increased laryngeal cancer risk (random-effects OR = 1.44, 95 % CI 1.19-1.73, P < 0.001). Subgroup analyses by ethnicity showed that the GSTM1 null genotype was associated with increased laryngeal cancer risk in both Caucasians (fixed-effects OR = 1.17, 95 % CI 1.04-1.33, P = 0.012) and Asians (random-effects OR = 1.89, 95 % CI 1.28-2.77, P = 0.001). Also, subgroup analyses by sample size also further identified this association above. The cumulative meta-analyses showed a trend of more obvious association between GSTM1 null genotype and increased risk of laryngeal cancer as information accumulated by year. Meta-analysis of available data suggests that GSTM1 null genotype contributes to increased laryngeal cancer risk in both Caucasians and East Asians.

Laryngeal Cancer: A 2‐Year Follow‐up Study

Objective: 1) To report the process of management and 2-year disease-free survival statistics for laryngeal cancer cases presenting to a United Kingdom tertiary cancer center. 2) To investigate which modality of treatment is the most appropriate for specific stages of laryngeal cancer. Method: A retrospective cohort study was carried out on laryngeal cancer patients presenting to a tertiary head and neck center from 2007 to 2009. Information on primary tumor staging and management was collected using the Somerset Cancer Registry. Patient notes, imaging, and histology reports were consulted to complete data retrieval. Results: Forty-seven cases presented during the study period (2 stage-0, 8 stage-I, 12 stage-II, 13 stage-III, 12 stage-IV). Nodal disease was present in 10.6%, and 2.1% had metastatic disease at presentation. Overall 2-year disease-free survival was 100% for stage-0, 87.5% stage-I, 69.2% stage-II, 36.4% stage-III, and 32.2% for stage-IV disease. Stage-I/II cases were treated by transoral laser (36.8%) or radiotherapy (63.2%), with 85.7% and 83.3% 2-year disease-free survival rates, respectively. Stage-III/IV cases were treated by surgery (38.1%) or radiotherapy/chemoradiotherapy (61.9%) with 2-year disease-free survival rates of 62.5% and 21.4%, respectively. Conclusion: Early-stage disease is equally well treated with transoral laser or radiotherapy alone in line with other studies. Larynx preservation with chemoradiotherapy demonstrates significantly poorer outcomes compared to surgery in this study. Accurate contemporary data recording is required to allow critical review of treatment modalities.

Novel mutations of OGG1 base excision repair pathway gene in laryngeal cancer patients

OGG1 (The human 8-oxoguanine glycosylase 1) is the primary enzyme in BER (base excision repair) pathway, responsible for the excision of 7, 8-dihydro-8-oxoguanine (8-oxoG), a mutagenic base byproduct that occurs as a result of exposure to reactive oxygen species. OGG1 gene is highly polymorphic among humans and is mutated in cancer cells. In this case control study, all exons of OGG1 gene and its exon/intron boundaries were amplified in 210 laryngeal cancer cases and 210 matched controls and then analyzed by single stranded conformational polymorphism. Amplified products showing altered mobility patterns were sequenced and analyzed. Two silent (Gln718Gln, His699-700His) and three missense (Ala597, Thr608-610Pro and Glu707Lys) mutations were observed in exon 2. In addition to this one missense mutation (1578G>A) was also observed in 3'UTR region. We found a significant association between OGG1 mutations and laryngeal cancer and observed that His699-His700, silent mutation exhibited an enhanced risk of ~9.0 folds (OR=9.07, 95% CI=4.73-17.39) and 1578G>A, missense mutation ~0.4 folds (OR=0.37, 95% CI=0.15-0.90). Furthermore, a positive association of OGG1 mutations with smoking was observed in laryngeal cancer cases when compared to controls. Heavy smokers have higher incidence of OGG1 mutations when compared to light smokers in present study. Our results demonstrate that OGG1 mutations are associated with an increased risk of laryngeal cancer. OGG1 mutations were found to accumulate more of 8-OHdG in smokers, which may serve as a biomarker for early diagnosis of laryngeal cancer.

Erken evre glottik larenks kanserinde radyoterapi sonuçları: Tek merkez deneyimi

Erken evre glottik larenks kanseri tanisi ile kuratif radyoterapi uygulanmis olgularda geriye donuk olarak tedavi sonuclarinin ve prognostik faktorlerin degerlendirilmesi amaclandi. 1993-2010 yillari arasinda klinigimizde radyoterapi uygulanan, biyopsi ile histopatolojik olarak kanser tanisi dogrulanmis ve RT oncesi herhangi bir tedavi uygulanmamis erken evre (T1-2N0) glottik larenks kanserli 73 olgu geriye donuk olarak incelendi. Tum olgularin verileri guncellenerek hasta, tumor ve tedaviye ait parametrelerin lokal-bolgesel kontrol ve sagkalim uzerine olan etkileri arastirildi. Hastalarin medyan yasi 60 (37-83) olup 69’u erkek, 4’u kadindir. Evrelere gore dagilim; 41’i (% 56,2) T1a, 8’i (% 10,9) T1b, 24’u (% 32,9) T2 seklindedir. Hastalara medyan 66 Gy (58,5-72) eksternal radyoterapi uygulanmistir. Radyoterapiye bagli olarak, 1 olguda (% 1,4) grade 3-4 erken ve gec larengeal odem gelismis, bu olgu disinda diger olgularin hicbirinde grade 3-4 erken ve gec toksisite ile karsilasilmamistir. Medyan 73 (5-209) aylik takipte toplam 10 (% 13,7) hastada lokal-bolgesel nuks saptanmis, hicbir olguda uzak metastaz saptanmamistir. Hastalarin 5 yillik lokal-bolgesel kontrol, hastaliga ozgu sagkalim ve genel sagkalim orani sirasi ile % 85, % 92 ve % 78’dir. Incelenen faktorlerden “tedaviye 5 gun ve daha fazla ara verilmesi” lokal-bolgesel kontrol ve hastaliga ozgu sagkalimi anlamli olarak azaltirken (sirasi ile p=0,008, p=0,036), “tedavi oncesi ses kisikligi suresinin 5 aydan az olmasinin” sadece lokal-bolgesel kontrolu anlamli olarak azalttigi (p=0,036) saptanmistir. Sonuc olarak, erken evre glottik larenks kanserinde primer tedavi olarak radyoterapi yuksek lokal kontrol oranlarina sahip etkin bir tedavi seklidir. Radyoterapiye cesitli nedenlerden dolayi verilen aralar lokal-bolgesel kontrolu ve hastaliga ozgu sagkalimi olumsuz etkileyen prognostik bir faktordur. Bu nedenle tedavi aralarindan mumkun oldugunca kacinilmalidir. Results of radiotherapy in early stage glottic laryngeal carcinoma: A single center experience Patients with early stage glottic laryngeal cancer treated with curative radiotherapy were aimed to evaluate retrospectively for their treatment results and prognostic factors. In between 1993-2010, early stage (T1-2N0) 73 glottic laryngeal cancer cases which were treated with radiotherapy in our department that histopathological diagnosis of cancer was confirmed by biopsy and without any treatment prior to RT, were retrospectively analyzed. Patient, tumor and treatment parameters of all cases were updated and their effects on the local-regional control and survival were investigated. The median age of patients was 60 (37-83) and 69 patients were male and 4 were female. The distributions of patients according to stages were as follows: 41 (56.2% ) T1a, 8 (10.9% ) T1b and 24 (32.9% ) T2. Median of 66 Gy (58.5-72) of external beam radiotherapy was delivered to patients. In a patient (1.4% ), grade 3-4 early and late laryngeal edema depending on radiotherapy was developed. In other patients except from this patient, early and late grade 3-4 toxicity was not observed. During a median 73 months (5-209) follow-up, local recurrence was detected in 10 (13.7% ) cases and no distant metastasis was observed. Five year local-regional control, disease-specific and overall survival rates were 85% , 92% and 78% , respectively. From the investigated factors, while 5 or more days treatment interruption was found to decrease significantly local-regional control and disease-specific survival (p=0.008, p=0.036, respectively), less than 5 months duration of hoarseness was found to decrease significantly only local-regional control (p=0.036). In conclusion, radiotherapy as primary treatment modality in the early stage laryngeal cancer is an effective form of treatment with high rates of local control. Radiotherapy interruption due to various reasons is a prognostic factor which adversely effects loco-regional control and disease-specific survival. Therefore, interruptions during the radiotherapy should be avoided as much as possible. J. Exp. Clin. Med., 2012; 29:141-147

Racial Disparities in the Use of Voice Preservation Therapy for Locally Advanced Laryngeal Cancer

To identify potential racial disparities in the use of larynx preservation. Retrospective database review. Academic medical center. The Surveillance Epidemiology and End Results (SEER) database was used to identify white, black, Hispanic, and Asian patients with stage III and IV laryngeal cancers that were diagnosed during 1991 through 2008. Patients with T4 disease or distant metastasis were intentionally excluded. Univariate and multivariate logistic regression analysis, with odds ratios and 95% confidence intervals, was used to investigate the relationship between race/ethnicity and the use of larynx preservation with radiation therapy as initial therapy. Among the 5385 cases of laryngeal cancers that met the selection criteria, the racial distribution was white (72.7%), black (16.8%), Hispanic (7.4%), and Asian (3.1%). On univariate analysis, blacks (odds ratio [OR], 0.72; 95% CI, 0.59-0.88) were significantly less likely to undergo larynx preservation. This racial disparity persisted on multivariate analysis for blacks (OR, 0.78; 95% CI, 0.63-0.96) and was still observed among patients treated more recently between 2001 and 2008 (OR, 0.74; 95% CI, 0.56-0.96). Pronounced racial disparities exist in the use of larynx preservation therapy for locally advanced laryngeal cancer. While acknowledging the potential biases of socioeconomic factors, further research to better elucidate the underlying reasons for these findings may be warranted.

Selenium and the risk of cancer of the lung and larynx. A case-control study from a region with low selenium

Selenium deficiency has been suggested by several studies to be associated with cancer risk. We conducted a case-control study in Szczecin, a region of northwestern Poland, on 86 cases of lung cancer, 87 cases of laryngeal cancer and an equal number of healthy controls. We studied the serum level of selenium and genotypes for four variants in four selenoprotein genes (GPX1, GPX4, TXNRD2 and SEP15) and the odds of being diagnosed with lung or laryngeal cancer. Among lung cancer cases, the mean selenium level was 63.2 µg/l, compared to a mean level of 74.7 µg/l for their matched controls (p 80 µg/l) was associated with an odds ratio of 0.10 (95% CI 0.03 to 0.34; p = 0.0002) for lung cancer and 0.24 (95% CI 0.10 to 0.59; p = 0.002) for laryngeal cancer. In four selenoproteins studied here we found a modest associations of genetic variants in GPX1 and GPX4 with lung and TXNRD2 with laryngeal cancer risk. In this region of endemic low selenium level, there is a strong inverse association between the level of serum selenium and the risks of lung and laryngeal cancer.

Afectación ganglionar en el cáncer de laringe y actitud terapéutica

AimsTry to establish a relationship between the presence or absence of lymphadenopathy in tumors of the larynx and the location of the tumor and discuss the treatment required in each case. MethodsData collection sheets were designed for the 224 laryngeal cancer cases diagnosed in the province of Guadalajara between 1975 and 1998, among those data we included the presence or absence of lymph nodes at the time of diagnosis, as well as its location and treatment applied in each patient. ResultsAbout in a half the cases studied had lymphadenopathy, being about in a half of the cases unilateral and about in a half of the cases bilaterals. The lymph nodes appeared more frequently in the supraglottic and hypopharyngeal tumors and less frequently in the glottic tumors. More extensive surgical interventions corresponded to supraglottic tumors and those affecting multiple levels of the larynx. Lymph node dissection was required in the 87% of supraglottic tumors and in 38.6% of the glottic tumors. ConclusionsThe bigger size of the tumor correlated with more cases with lymphadenopathies and a more extensive treatment had to be applied.

Trends in Total Laryngectomy in the Era of Organ Preservation

To describe time trends in total laryngectomy health services utilization across the United States, such as rates of surgery, cost, length of stay, and insurance payer, and to compare this to important milestones in recommendations for laryngeal cancer treatment. Population-based cohort study. Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) 1997-2008: stratified sample of all US hospital discharges. All patients with the principal procedure of complete laryngectomy. The unit of analysis was the discharge. Between 1997 and 2008, the number of laryngectomies done in the United States decreased by 48%. New cases of laryngeal cancer decreased 33% during the same time. The proportion of patients older than 65 years decreased from 48% to 43%. Mortality for the procedure was 1.4% in 1997 and 1.1% in 2008. Mean length of stay over the study period increased from 13 days to 14 days. Mean hospital charges rose from $58,000 in 1997 to $109,000 in 2008, consistent with the overall rise in US health care costs. Medicare was the dominant insurer throughout. Home health was ordered in 50% of 2008 discharges but only 32% in 1997. The rate of total laryngectomy has dropped more than the incidence of laryngeal cancer has dropped, consistent with the trend toward nonsurgical treatment. Lower surgical volumes and/or salvage laryngectomy surgeries are hypothesized to play a role in longer length of stay, stable mortality rates despite younger patient age, and increased need for home services after discharge.

Lack of association between glutathione S-transferase T1 gene polymorphism and laryngeal cancer susceptibility: A meta-analysis based on 2,124 cases and 2,059 controls

Studies investigating the association between glutathione S-transferase T1 (GSTT1) gene polymorphism and laryngeal cancer susceptibility have reported conflicting results. The aim of the present study was to conduct a meta-analysis assessing the possible association of GSTT1 gene polymorphism with laryngeal cancer risk. The relevant studies were identified through a search of PubMed, Embase, ISI Web of Knowledge and Chinese National Knowledge Infrastructure until May 2011. Twelve studies were included in the present meta-analysis, which described a total of 2124 laryngeal cancer cases and 2059 controls. The overall odds ratio (OR) for GSTT1 null genotype was 1.40 (95% CI=0.90–2.16). When stratifying for race, the pooled ORs for GSTT1 null genotype were 1.07 (95% CI=0.81–1.41) in Caucasians and 5.63 (95% CI=1.00–31.83) in Asians. The pooled ORs for GSTT1 null genotype were 1.03 (95% CI=0.71–1.49) in population-based studies and 2.39 (95% CI=0.73–7.86) in hospital-based studies, stratifying for study design. This meta-analysis suggested that there was lack of association between GSTT1 gene polymorphism and laryngeal cancer risk. However, larger scale primary studies are still required to further evaluate the interaction of GSTT1 gene polymorphism with laryngeal cancer risk.

Temporal Trends in the Treatment of Early- and Advanced-Stage Laryngeal Cancer in the United States, 1985-2007

To describe trends and 4-year survival rate of surgical and nonsurgical treatment for laryngeal cancer. Observational cross-sectional study. A total of 131694 cases of laryngeal cancer diagnosed from 1985 to 2007 identified from the National Cancer Database. Primary treatment information, including radiation therapy (RT), chemoradiation (CRT), and curative intent surgery, were identified. The association between treatment and the patient's clinical and nonclinical variables was analyzed using univariate and multivariate statistics. The 4-year survival rate was generated through Kaplan-Meier estimates, and multivariate Cox proportional hazard models were used to generate hazard ratios. Among patients with early-stage cancer, the proportion receiving primary surgery increased (from 20% in 1985 to 33% in 2007), whereas the use of RT decreased from 64% to 52%. Patients with early-stage cancer who resided in areas with higher socioeconomic status (SES) zip codes, had private insurance, who were not African American, and who were treated at academic facilities were more likely to receive surgery. The 4-year survival rate for patients with early-stage laryngeal cancer treated with surgery was higher than the rate for those treated with RT (79% vs 71%). Among patients with advanced-stage cancer, the use of CRT increased from less than 7% to 45%, whereas the use of total laryngectomy decreased from 42% to 32%. The use of CRT was more common among patients who resided in areas with higher SES zip codes, had private insurance, and who were younger. The 4-year survival rates for patients with advanced laryngeal cancer treated with total laryngectomy, CRT, and RT were 51%, 48%, and 38%, respectively. Factors associated with an increased risk of death from advanced laryngeal cancer included receiving CRT and race/ethnicity. Among patients with early-stage laryngeal cancer, we observed an increasing proportion of primary surgical therapy during this study period. Among patients with advanced-stage cancer, we observed an increasing proportion of CRT. Not only were clinical factors associated with type of treatment, but select sociodemographic elements were also associated with treatment. Further investigation as to the decision-making process of patients with different sociodemographic backgrounds will assist in mitigating the differences in survival for this group of patients.