European Archives of Oto-Rhino-Laryngology

, Volume 267, Issue 7, pp 1095–1101

Survival after laryngectomy: a review of 133 patients with laryngeal carcinoma

  • Theodoros A. Papadas
  • Evangelos C. Alexopoulos
  • Antony Mallis
  • Eleni Jelastopulu
  • Nicholas S. Mastronikolis
  • Panos Goumas


Survival trends in survival for laryngeal cancer in Europe are varied. Five-year survival varied around 60–64% but numbers below 50% have been commonly reported. The aim of this study was to assess the factors influencing survival in patients with laryngeal cancer in our region. A total of 128 male and 5 female patients with larynx cancer (91 glottic and 42 supraglottic) were treated at Patras University Hospital between March 1992 and August 2004. Except 3, all were smokers and 56 (41%) heavy alcohol users. Postsurgical staging showed that most had been classified at stages III (38%) and IV (49%). By histology, 31 tumors were classified as poorly differentiated, 78 as moderately differentiated and 23 as well differentiated. All patients underwent laryngectomy with extension of the procedure where appropriate. Also, a total of 45 patients received adjuvant therapy (either chemotherapy or radiotherapy). Farmers, construction workers, professional drivers and mechanics and coffee shop and bar employees account for more than 70% of patients. Results showed that 64 (48.1%) patients died during the follow-up, 58 (43.6%) of them died from cause related to their disease. With a median follow-up of 25 months, the 5-year disease-free survival (DFS) was 53% and the 5-year overall survival (OS) was 45%. Significant prognostic factors for OS included patient age, advanced staging, heavy alcohol use and poor tumor differentiation while for DFS affected mainly by poor tumor differentiation. We conclude that the disease stage at presentation, tumor grade and alcohol consumption prove to be important predictors for the OS as well as the DFS in our series.


Laryngeal carcinoma Laryngectomy Cohort study Survival analysis Prognostic factors Alcohol Occupational exposure Greece 


  1. 1.
    Lin HW, Bhattacharyya N (2008) Staging and survival analysis for nonsquamous cell carcinomas of the larynx. Laryngoscope 118(6):1003–1013CrossRefPubMedGoogle Scholar
  2. 2.
    Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics 2002. CA Cancer J Clin 55:74–108CrossRefPubMedGoogle Scholar
  3. 3.
    Ferlay J, Autier P, Boniol M, Heanue M, Colombet M, Boyle P (2007) Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol 18:581–592CrossRefPubMedGoogle Scholar
  4. 4.
    Marioni G, Marchese-Ragona R, Cartei G, Marchese F, Staffieri A (2006) Current opinion in diagnosis and treatment of laryngeal carcinoma. Cancer Treat Rev 32(7):504–515CrossRefPubMedGoogle Scholar
  5. 5.
    Boyle P, Levin B (eds) (2008) World Cancer Report 2008. International Agency for Research on Cancer (IARC), LyonGoogle Scholar
  6. 6.
    Berrino F, De Angelis R, Sant M, Rosso S, Bielska-Lasota M, Coebergh JW, Santaquilani M, EUROCARE Working group (2007) Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995–99: results of the EUROCARE-4 study. Lancet Oncol 8(9):773–783CrossRefPubMedGoogle Scholar
  7. 7.
    Menvielle G, Luce D, Goldberg P, Bugel I, Leclerc A (2004) Smoking, alcohol drinking and cancer risk for various sites of the larynx and hypopharynx. A case-control study in France. Eur J Cancer Prev 13(3):165–172CrossRefPubMedGoogle Scholar
  8. 8.
    Maier H, Gewelke U, Dietz A, Heller WD (1992) Risk factors of cancer of the larynx: results of the Heidelberg case-control study. Otolaryngol Head Neck Surg 107:577–582PubMedGoogle Scholar
  9. 9.
    La Vecchia C, Zhang ZF, Altieri A (2008) Alcohol and laryngeal cancer: an update. Eur J Cancer Prev 17(2):116–124CrossRefPubMedGoogle Scholar
  10. 10.
    Di Nicola V, Resta L, Rotundo L, Fiorella ML, Fiorella R (1999) Evaluation of resection margins as a prognostic factor in the surgical treatment of laryngeal carcinoma. Acta Otorhinolaryngol Ital 19(6):325–341PubMedGoogle Scholar
  11. 11.
    Nguyen-Tan PF, Le QT, Quivey JM, Singer M, Terris DJ, Goffinet DR, Fu KK (2001) Treatment results and prognostic factors of advanced T3–4 laryngeal carcinoma: the University of California, San Francisco (UCSF) and Stanford University Hospital (SUH) experience. Int J Radiat Oncol Biol Phys 50(5):1172–1180PubMedGoogle Scholar
  12. 12.
    Groome P, Mackillop WJ (2000) Management and outcome of glottic cancer: a population based comparison between Ontario Canada and the SEER areas of the United States. J Otolaryyngol 29:67–77Google Scholar
  13. 13.
    Department of Veterans Affairs Laryngeal Cancer Study Group (1991) Induction chemotherapy plus radiation compared with surgery plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 324:1685–1690CrossRefGoogle Scholar
  14. 14.
    Matsuo JM, Patel SG, Singh B, Wong RJ, Boyle JO, Kraus DH, Shaha AR, Zelefsky MJ, Pfister DG, Shah JP (2003) Clinical nodal stage is an independently significant predictor of distant failure in patients with squamous cell carcinoma of the larynx. Ann Surg 238(3):412–422PubMedGoogle Scholar
  15. 15.
    Lohynska R, Slavicek A, Bahanan A, Novakova P (2005) Predictors of local failure in early laryngeal cancer. Neoplasma 52(6):483–488PubMedGoogle Scholar
  16. 16.
    Tomasino RM, Bazan V, Daniele E, Nuara R, Morello V, Tralongo V, Leto G, Russo A (1996) Biological characterization of laryngeal squamous-cell carcinoma. Anticancer Res 16(4B):2257–2267PubMedGoogle Scholar
  17. 17.
    American Joint Committee on Cancer (1997) Cancer staging manual, 5th edn. Lippincott–Raven, Philadelphia, pp 24–30Google Scholar
  18. 18.
    Kubrak J, Jarema A, Falco M, Rogowska D, Rubik A, Torbé B (2008) An analysis of factor influencing the outcome of patients with locally advanced larynx cancer. Otolaryngol Pol 62(6):691–694PubMedGoogle Scholar
  19. 19.
    Jones AS, Fish B, Fenton JE, Husband DJ (2004) The treatment of early laryngeal cancers (T1–T2 N0): surgery or irradiation? Head Neck 26(2):127–135CrossRefPubMedGoogle Scholar
  20. 20.
    Wortley P, Vaughan TL, Davis S, Morgan MS, Thomas DB (1992) A case-control study of occupational risk factors for laryngeal cancer. Br J Ind Med 49(12):837–844PubMedGoogle Scholar
  21. 21.
    Hoffman HT, Porter K, Karnell LH, Cooper JS, Weber RS, Langer CJ, Ang KK, Gay G, Stewart A, Robinson RA (2006) Laryngeal cancer in the United States: changes in demographics, patterns of care, and survival. Laryngoscope 116(9 Pt 2 Suppl 111):1–13Google Scholar
  22. 22.
    Stephenson WT, Barnes DE, Holmes FF, Norris CW (1991) Gender influences subsite of origin of laryngeal carcinoma. Arch Otolaryngol Head Neck Surg 117(7):774–778PubMedGoogle Scholar
  23. 23.
    Hu C, Wang B, Huangfu H, Liu T, Xia L, Zhou L (2007) Survival analysis of 315 cases of laryngectomy. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 21(10):466–467PubMedGoogle Scholar
  24. 24.
    Mendenhall WM, Werning JW, Hinerman RW, Amdur RJ, Villaret DB (2004) Management of T1–T2 glottic carcinomas. Cancer 100(9):1786–1792CrossRefPubMedGoogle Scholar
  25. 25.
    Spector GJ, Sessions DG, Lenox J, Newland D, Simpson J, Haughey BH (2004) Management of stage IV glottic carcinoma: therapeutic outcomes. Laryngoscope 114(8):1438–1446CrossRefPubMedGoogle Scholar
  26. 26.
    Olsen J, Sabreo S, Fasting U (1985) Interaction of alcohol and tobacco as risk factors in cancer of the laryngeal region. J Epidemiol Community Health 39(2):165–168CrossRefPubMedGoogle Scholar
  27. 27.
    Trigg DJ, Lait M, Wenig BL (2000) Influence of tobacco and alcohol on the stage of laryngeal cancer at diagnosis. Laryngoscope 110(3 Pt 1):408–411CrossRefPubMedGoogle Scholar
  28. 28.
    Guénel P, Chastang JF, Luce D, Leclerc A, Brugère J (1988) A study of the interaction of alcohol drinking and tobacco smoking among French cases of laryngeal cancer. J Epidemiol Community Health 42(4):350–354CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Theodoros A. Papadas
    • 1
  • Evangelos C. Alexopoulos
    • 2
  • Antony Mallis
    • 1
  • Eleni Jelastopulu
    • 2
  • Nicholas S. Mastronikolis
    • 1
  • Panos Goumas
    • 1
  1. 1.ENT DepartmentUniversity Hospital of PatrasPatrasGreece
  2. 2.Department of Public Health Medical SchoolUniversity of PatrasPatrasGreece

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