Laryngeal Cancer Attributable Factors and the Influence on Survival Rates: A Single Brazilian Institution Experience

Abstract

Introduction Epidemiological studies focused on prognostic factors associated with laryngeal cancer in the Brazilian population are poorly reported in the literature. Objective To evaluate the influence of certain risk factors on the survival rates of patients with squamous cell carcinoma (SCC) of the larynx. Methods This retrospective study was conducted on adult patients who were admitted to the outpatient clinic of the head and neck department in a tertiary care hospital. Evaluation of the influence of risk factors on the survival rates of patients registered in the hospital with laryngeal SCC was performed based on age, sex, initial stage, time of evolution, habits, educational levels and relapse and death. Overall survival (OS), disease-free survival (DFS) and clinical-demographic data were analyzed using the Kaplan-Meier method, Log-rank test and Cox regression. Results A total of 107 patients with a mean age of 59.8 years (range 19-81) were included in this study. Stages III and IV were associated with decreased DFS ( p = 0.02) and OS ( p = 0.02). Smoking patients had a greater period of disease evolution than non-smoking patients ( p = 0.003). Alcohol consumption in smokers increased the risk of death by 2.8 ( p = 0.002) compared with non-drinking smokers. Male patients presented lower DFS average when compared with female patients ( p = 0.04). Conclusion Our study confirms that male gender, smoking habit combined with alcohol consumption, and advanced stages were strongly associated with poor prognosis.

Keywords: alcohol drinking; cancer of the larynx; smoke; survival analysis.

Fig. 1

Kaplan-Meier plots of overall and disease-free survival (Log-Rank and Cox-regression test), (A) and (C) Comparing male gender versus female gender, with decreased overall survival (OS) and disease-free survival (DFS) for men, and statistical significance for DFS ( p  = 0.04); (E) and (G) comparing stages I + II versus stages III + IV, showed no significant decrease OS ( p  = 0.08) and significant DFS ( p  = 0.02) for advanced stages (III + IV); (B) comparing smokers versus non-smokers (without habit) that presented decreased OS ( p  = 0.003); (F) and (H) comparing absence of habits versus both factors (smoker and drinking) versus one habit (only smokers) show significant difference among the three condition, with the worst results for non-habits OS ( p  = 0.001) and DFS ( p  = 0.005); (D) comparing alcohol consumption versus no alcohol consumption, results showed decreased DFS for alcoholic ( p  = 0.002).