European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 3, pp 547–554 | Cite as

Survival outcome depending on different treatment strategies in advanced stages III and IV laryngeal cancers: an audit of data from two European centres

  • Therese R. Karlsson
  • Mohammed Al-Azzawe
  • Luaay Aziz
  • David Hurman
  • Caterina Finizia
Laryngology

Abstract

In light of continued uncertainty regarding efficacy of treatment of Stages III and IV laryngeal tumours, this study aims to evaluate organ-preservation strategies, comprising radiotherapy and chemoradiotherapy versus surgical treatment (laryngectomy ± adjuvant treatment) by encompassing the long-established practice at two internationally acclaimed tertiary centres not previously presented in published literature. Retrospective review was conducted of non-randomised prospectively maintained Stages III and IV disease patient databases at two tertiary centres: Sahlgrenska University Hospital (SU) in Gothenburg, Sweden, and Aberdeen Royal Infirmary (ARI) in Aberdeen, Scotland. Primary outcome measures included 3-year overall, disease-specific survival and local control depending on treatment. A total of 176 patients were identified. Sixty-five patients (37 %) presented with Stage III tumours, of which 51 patients received organ-preserving treatment and 14 underwent total laryngectomy. The corresponding figures for the 111 patients (63 %) presenting with Stage IV disease were 42 and 69. Three-year overall and disease-specific survival for Stage III was 58 and 73 %, respectively. The corresponding figures for Stage IV disease were 42 and 53 %. The choice of treatment did not appear to significantly influence survival for Stage III (p = 0.56) or IV (p = 0.93) disease. The choice of treatment, whether organ preservation or surgery, does not seem to significantly influence the overall or disease-specific survival. Therefore, other factors such as quality of life and voice and efficacy of salvage treatments are perhaps more likely to indicate the preferred treatment options, but larger randomised trials are needed.

Keywords

Laryngeal neoplasm Radiotherapy Laryngectomy Survival Advanced disease 

Notes

Acknowledgments

The authors would like to thank Erik Holmberg at the Regionalt Cancer Centrum Väst for his help with statistical analysis. This study was supported by the Swedish Cancer Society, the Research and Development Council, Västra Götaland (Sweden) County and the Medical Faculty of Gothenburg University Sweden.

Conflict of Interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Therese R. Karlsson
    • 1
  • Mohammed Al-Azzawe
    • 1
  • Luaay Aziz
    • 1
  • David Hurman
    • 2
  • Caterina Finizia
    • 1
  1. 1.Department of Otorhinolaryngology, Head and Neck Surgery Sahlgrenska University HospitalGothenburg UniversityGothenburgSweden
  2. 2.Department of Clinical OncologyAberdeen Royal InfirmaryAberdeenUK

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