In Advanced Laryngeal Cancer, Survival Advantage Seen with Surgery
(HealthDay News) — For patients with advanced laryngeal cancer, there is a small but significant survival advantage with surgical treatment versus laryngeal conservation, according to a study published online August 21 in JAMA Otolaryngology-Head & Neck Surgery.
Uchechukwu C. Megwalu, MD, MPH, and Andrew G. Sikora, MD, PhD, from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues conducted a population-based study involving 5,394 patients who received a diagnosis of stage III or IV laryngeal squamous cell carcinoma from 1992–2009. Survival outcomes were assessed for laryngeal conservation vs. surgical therapy.
The researchers found that two-year and five-year disease-specific (DSS) and overall survival (OS) were better for patients undergoing surgical therapy vs. nonsurgical therapy (DSS: 70 vs. 64% and 55 vs. 51%, respectively; P<0.001; OS: 64 vs. 57% and 44 vs. 39%, respectively; P<0.001). After stratification by year-of-diagnosis cohorts, the between-group difference in DSS and OS remained significant (P<0.001). With subsequent year-of-diagnosis cohorts, the survival gap narrowed consistently. After adjustment for multiple confounding variables, nonsurgical patients had worse DSS and OS (hazard ratios, 1.33 and 1.32, respectively).
"Patients need to be made aware of the modest but significant survival disadvantage associated with nonsurgical therapy as part of the shared decision-making process during treatment selection," the authors write.