Survival analysis of laryngeal squamous cell cancer, considering different treatment modalities and other factors influencing survival - a monocentric retrospective investigation

Abstract

Purpose: This study aimed to investigate the factors affecting laryngeal cancer survival.

Methods: This study retrospectively analysed laryngeal cancer types, treatment options, and potential factors influencing survival.

Results: 77 patients (26.27%) had supraglottic laryngeal cancer, 209 (70.13%) had glottic laryngeal cancer, and 7 (3.6%) had subglottic laryngeal cancer. Common comorbidities such as type 2 diabetes mellitus, chronic obstructive pulmonary disease, and coronary disease were observed in 13.65%, 11.9%, and 22.18% of the patients, respectively. Smoking was detected in 88.05% of the patients, while 56.3% reported regular alcohol consumption. The study found that hemilaryngectomy and supraglottic horizontal resection led to significantly longer survival compared to other treatment options (i.e., total laryngectomy, supracricoid horizontal partial laryngectomy, transoral laser cordectomy, chemoradiation, chemotherapy, and radiotherapy), p = 0.000*. Glottic cancers tend to have longer survival when considering laryngeal cancer locations; however, this difference was statistically insignificant (p = 0.640). Statistical comparisons showed significantly longer survival rates for surgical treatments in stages 1 (p = 0.007*) and 4 (p = 0.007*). Factors such as coronary artery disease, higher ECOG performance status, advanced 'N' stages, and higher tumour grades were found to significantly worsen survival, as determined by a Cox proportional hazards model.

Conclusion: The study revealed that factors such as coronary disease, patients' functionality, 'N' stages, and tumour grade significantly impacted survival rates. Furthermore, the study found that supraglottic horizontal resection and hemilaryngectomy resulted in the longest survival. Surgical methods were associated with significantly longer survival rates in disease stages 1 and 4.

Keywords: Chemoradiation; Influencing factors; Larynx cancer; Surgery; Survival; p16 expression.

Fig. 1

Kaplan–Meier analysis on survival (months) depending on different treatment modalities. The blue line represents total laryngectomy, the red line represents supracricoid horizontal partial laryngectomy, the dark green line represents supraglottic horizontal resection, the orange line represents hemilaryngectomy, the yellow line represents transoral laser cordectomy, the turquoise line represents chemoradiation, the pink line represents chemotherapy, the purple line represents radiotherapy, and the light green line refers to cases where no treatment was received. The p-value was calculated using the log-rank (Mantel–Cox) test (p < 0.05*). The asterisk (*) indicates a statistically significant difference. CI = confidence interval; OS = overall survival; Std. = standard OS = overall survival

Fig. 2

Kaplan–Meier analysis on survival (months) depending on larynx cancer stages and surgical and non-surgical treatment modalities. The blue line consistently indicates surgical treatment, while the red line represents non-surgical treatment. Non-surgical treatment modalities include primary radiotherapy for stage 1 and 2 groups, and chemoradiation for stage 3 and 4 groups

Fig. 3

Kaplan–Meier analysis on survival (months) depending on different treatment modalities. The blue line represents subglottic cancer, the red line represents glottic cancer and the green line represents supraglottic cancer. The p-value was calculated using the log-rank (Mantel–Cox) test (p < 0.05*). OS = overall survival