Skip to main content

Advertisement

SpringerLink
Log in

The primary tumor resection in patients with distant metastatic laryngeal carcinoma

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Background

The role of primary tumor resection in patients with distant metastatic laryngeal carcinoma (DMLC) has not been clarified completely. Thus, we used propensity score matching (PSM) and survival analysis to address this issue.

Methods

The PSM was utilized to avoid selection bias and disproportionate distributions of the confounding factors. Kaplan–Meier estimates and Cox proportional hazard analysis were utilized to evaluate overall survival (OS) and cancer-specific survival (CSS).

Results

From the Surveillance, Epidemiology, and End Results Program database, a cohort of 480 patients with DMLC were included. After PSM, the OS and CSS for patients who underwent resection were significantly longer than those without resection (median OS: 19 months vs. 8 months, P < 0.001; median CSS: 19 months vs. 9 months, P = 0.002). Tumor resection significantly prolonged survival of DMLC patients with appropriate demographic and clinical characteristics. In the multivariate analysis, age at diagnosis, race, pathologic subtype, and marital status were found significantly affecting both OS and CSS of patients who underwent surgical resection. Predictive nomograms were developed to help distinguish patients with early mortality potential after surgical resection.

Conclusions

This study is the first one using PSM to assess the role played by surgical resection in DMLC and evaluate the prognostic factor of resected patients. Premised on well controlled postoperative complications, resection could significantly prolong OS and CSS of certain patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

These data were derived from The Surveillance, Epidemiology, and End Results (SEER) Program and available in the public domain: https://seer.cancer.gov/.

Abbreviations

LC:

Laryngeal carcinoma

DMLC:

Distant metastasis of laryngeal carcinoma

RT:

Radiation

CRT:

Chemoradiotherapy

NCCN:

National Comprehensive Cancer Network

PSM:

Propensity score matching

AJCC:

American Joint Committee on Cancer

SCC:

Squamous-cell carcinoma

OS:

Overall survival

CSS:

Cancer-specific survival

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68(6):394–424. https://doi.org/10.3322/caac.21492

    Article  PubMed  Google Scholar 

  2. Liu JC, Bhayani M, Kuchta K, Galloway T, Fundakowski C (2019) Patterns of distant metastasis in head and neck cancer at presentation: implications for initial evaluation. Oral Oncol 88:131–136. https://doi.org/10.1016/j.oraloncology.2018.11.023

    Article  PubMed  Google Scholar 

  3. Kowalski LP, Carvalho AL (2000) Natural history of untreated head and neck cancer. Eur J Cancer 36(8):1032–1037. https://doi.org/10.1016/s0959-8049(00)00054-x

    Article  CAS  PubMed  Google Scholar 

  4. Schulz D, Wirth M, Piontek G, Knopf A, Straube C, Pigorsch S, Combs SE, Pickhard A (2018) Improved overall survival in head and neck cancer patients after specific therapy of distant metastases. Eur Arch Otorhinolaryngol 275(5):1239–1247. https://doi.org/10.1007/s00405-018-4920-9

    Article  PubMed  Google Scholar 

  5. Wiegand S, Zimmermann A, Wilhelm T, Werner JA (2015) Survival after distant metastasis in head and neck cancer. Anticancer Res 35(10):5499–5502

    PubMed  Google Scholar 

  6. Ray A, Khalil MI, Pulakanti KL, Burns RT, Gurski CJ, Basu S, Wang D, Rao S, Dittel BN (2019) Mature IgD(low/-) B cells maintain tolerance by promoting regulatory T cell homeostasis. Nat Commun 10(1):190. https://doi.org/10.1038/s41467-018-08122-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. National Comprehensive Cancer Network (NCCN) (2019) Clinical Practice Guidelines in Oncology. Head and neck cancers (Version 3). https://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf. Accessed 16 Sept 2019

  8. Patel TD, Marchiano E, Chin OY, Kilic S, Eloy JA, Baredes S, Park RCW (2016) Utility of surgery/radiotherapy in distant metastatic head and neck squamous cell carcinoma: a population-based approach. Otolaryngol Head Neck Surg 154(5):868–874. https://doi.org/10.1177/0194599815627637

    Article  PubMed  Google Scholar 

  9. Pan Y, Hong Y, Liang Z, Zhuang W (2019) Survival analysis of distant metastasis of laryngeal carcinoma: analysis based on SEER database. Eur Arch Oto-rhino-laryngol Off J Eur Feder Oto-Rhino-Laryngol Soc (EUFOS) Affiliat German Soc Oto-Rhino-Laryngol Head Neck Surg 276(1):193–201. https://doi.org/10.1007/s00405-018-5244-5

    Article  Google Scholar 

  10. Jones EA, Shuman AG, Egleston BL, Liu JC (2019) Common pitfalls of head and neck research using cancer registries. Otolaryngol Head Neck Surg 161(2):245–250. https://doi.org/10.1177/0194599819838823

    Article  PubMed  PubMed Central  Google Scholar 

  11. Feuer EJ, Lee M, Mariotto AB, Cronin KA, Scoppa S, Penson DF, Hachey M, Cynkin L, Carter GA, Campbell D, Percy-Laurry A, Zou Z, Schrag D, Hankey BF (2012) The Cancer Survival Query System: making survival estimates from the surveillance, epidemiology, and end results program more timely and relevant for recently diagnosed patients. Cancer 118(22):5652–5662. https://doi.org/10.1002/cncr.27615

    Article  PubMed  Google Scholar 

  12. Kowalski LP, Carvalho AL, Martins Priante AV, Magrin J (2005) Predictive factors for distant metastasis from oral and oropharyngeal squamous cell carcinoma. Oral Oncol 41(5):534–541. https://doi.org/10.1016/j.oraloncology.2005.01.012

    Article  PubMed  Google Scholar 

  13. Morgan CJ (2018) Reducing bias using propensity score matching. J Nucl Cardiol 25(2):404–406. https://doi.org/10.1007/s12350-017-1012-y

    Article  PubMed  Google Scholar 

  14. Rosenbaum PR, Rubin DB (1983) The central role of the propensity score in observational studies for causal effects. Biometrika 70(1):41–55. https://doi.org/10.1093/biomet/70.1.41/JBiometrika

    Article  Google Scholar 

  15. Cuzick J (2005) Forest plots and the interpretation of subgroups. Lancet 365(9467):1308

    Article  PubMed  Google Scholar 

  16. Steuer CE, El-Deiry M, Parks JR, Higgins KA, Saba NF (2017) An update on larynx cancer. CA Cancer J Clin 67(1):31–50. https://doi.org/10.3322/caac.21386

    Article  PubMed  Google Scholar 

  17. Ferris RL, Blumenschein G Jr, Fayette J, Guigay J, Colevas AD, Licitra L, Harrington K, Kasper S, Vokes EE, Even C, Worden F, Saba NF, Iglesias Docampo LC, Haddad R, Rordorf T, Kiyota N, Tahara M, Monga M, Lynch M, Geese WJ, Kopit J, Shaw JW, Gillison ML (2016) Nivolumab for recurrent squamous-cell carcinoma of the head and neck. N Engl J Med 375(19):1856–1867. https://doi.org/10.1056/NEJMoa1602252

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Harrington KJ, Ferris RL, Blumenschein G Jr, Colevas AD, Fayette J, Licitra L, Kasper S, Even C, Vokes EE, Worden F, Saba NF, Kiyota N, Haddad R, Tahara M, Grunwald V, Shaw JW, Monga M, Lynch M, Taylor F, DeRosa M, Morrissey L, Cocks K, Gillison ML, Guigay J (2017) Nivolumab versus standard, single-agent therapy of investigator's choice in recurrent or metastatic squamous cell carcinoma of the head and neck (CheckMate 141): health-related quality-of-life results from a randomised, phase 3 trial. Lancet Oncol 18(8):1104–1115. https://doi.org/10.1016/S1470-2045(17)30421-7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Xu J, Lu D, Zhang L, Li J, Sun G (2019) Palliative resection or radiation of primary tumor prolonged survival for metastatic esophageal cancer. Cancer Med. https://doi.org/10.1002/cam4.2609

    Article  PubMed  PubMed Central  Google Scholar 

  20. Zhang R, Zou J, Li P, Li Q, Qiao Y, Han J, Huang K, Ruan P, Lin H, Song Q, Fu Z (2019) Surgery to the primary tumor is associated with improved survival of patients with metastatic esophageal cancer: propensity score-matched analyses of a large retrospective cohort. Dis Esophagus. https://doi.org/10.1093/dote/doz051

    Article  PubMed  Google Scholar 

  21. Turner N, Tran B, Tran PV, Sinnathamby M, Wong HL, Jones I, Croxford M, Desai J, Tie J, Field KM, Kosmider S, Bae S, Gibbs P (2015) Primary tumor resection in patients with metastatic colorectal cancer is associated with reversal of systemic inflammation and improved survival. Clin Colorectal Cancer 14(3):185–191. https://doi.org/10.1016/j.clcc.2015.02.004

    Article  PubMed  Google Scholar 

  22. Flanigan RC, Mickisch G, Sylvester R, Tangen C, Van Poppel H, Crawford ED (2004) Cytoreductive nephrectomy in patients with metastatic renal cancer: a combined analysis. J Urol 171(3):1071–1076. https://doi.org/10.1097/01.ju.0000110610.61545.ae

    Article  PubMed  Google Scholar 

  23. Argiris A, Karamouzis MV, Raben D, Ferris RL (2008) Head and neck cancer. Lancet (London, England) 371(9625):1695–1709. https://doi.org/10.1016/S0140-6736(08)60728-X

    Article  CAS  Google Scholar 

  24. Clark TG, Murphy MFG, Hey K, Drury M, Cheng KK, Aveyard P (2006) Does smoking influence survival in cancer patients through effects on respiratory and vascular disease? Eur J Cancer Prev 15(1):87–90

    Article  PubMed  Google Scholar 

  25. Fritsch VA, Lentsch EJ (2014) Basaloid squamous cell carcinoma of the head and neck: location means everything. J Surg Oncol 109(6):616–622. https://doi.org/10.1002/jso.23536

    Article  PubMed  Google Scholar 

  26. Yeh DH, Sahovaler A, Fung K (2017) Reconstruction after salvage laryngectomy. Oral Oncol 75:22–27. https://doi.org/10.1016/j.oraloncology.2017.10.009

    Article  PubMed  Google Scholar 

  27. Bourhis J, Sire C, Graff P, Gregoire V, Maingon P, Calais G, Gery B, Martin L, Alfonsi M, Desprez P, Pignon T, Bardet E, Rives M, Geoffrois L, Daly-Schveitzer N, Sen S, Tuchais C, Dupuis O, Guerif S, Lapeyre M, Favrel V, Hamoir M, Lusinchi A, Temam S, Pinna A, Tao YG, Blanchard P, Auperin A (2012) Concomitant chemoradiotherapy versus acceleration of radiotherapy with or without concomitant chemotherapy in locally advanced head and neck carcinoma (GORTEC 99–02): an open-label phase 3 randomised trial. Lancet Oncol 13(2):145–153. https://doi.org/10.1016/s1470-2045(11)70346-1

    Article  PubMed  Google Scholar 

  28. Grover S, Mitra N, Wan F, Lukens JN, Sharma S, Bauman J, Masroor F, Cohen RB, Desai A, Algazy K, Alonso-Basanta M, Ahn P, Kevin Teo B-K, Chalian AA, Weinstein GS, O'Malley BW, Lin A (2016) A single-institution comparison of cetuximab, carboplatin, and paclitaxel induction chemotherapy followed by chemoradiation (crt) versus crt for locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). Am J Clin Oncol 39(5):522–527. https://doi.org/10.1097/COC.0000000000000085

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Author notes

  1. Zhongyang Lin and Hanqing Lin contributed equally to this work as first author.

Authors and Affiliations

  1. Department of Otolaryngology, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Fuzhou, 350005, Fujian Province, China

    Zhongyang Lin, Xihang Chen, Yuanteng Xu, Xiaobo Wu, Xiaoying Ke & Chang Lin

  2. Department of Otolaryngology, Eye Ear Nose and Throat Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, China

    Hanqing Lin

Authors
  1. Zhongyang Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hanqing Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xihang Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yuanteng Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xiaobo Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xiaoying Ke
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Chang Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conception and design: ZYL, HQL, CL; Administrative support: XHC, YTX, CL; Provision of study materials or patients: ZYL, HQL; Collection and assembly of data: ZYL, HQL, XHC; Data analysis and interpretation: ZYL, HQL; Manuscript writing: All authors; Final approval of manuscript: All authors.

Corresponding author

Correspondence to Chang Lin.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical statement

The identifiable patient information is not contained in the publicly available SEER database, no ethical approvals were required. It was exempt by the Ethic Committee of the First Affiliated Hospital of Fujian Medical University (Fuzhou, China).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lin, Z., Lin, H., Chen, X. et al. The primary tumor resection in patients with distant metastatic laryngeal carcinoma. Eur Arch Otorhinolaryngol 277, 2859–2868 (2020). https://doi.org/10.1007/s00405-020-05987-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-020-05987-9

Keywords

Search

Navigation