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Stage Migration and Survival Trends in Laryngeal Cancer

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

During the last two decades, significant advancements in the treatment of laryngeal cancer have occurred. Although survival of head and neck cancer patients has improved over time, the temporal trend of laryngeal cancer survival is an area of controversy.

Methods

From 2004 to 2016, 77,527 patients who had laryngeal cancer treated with curative intent in the United States were identified in the National Cancer Database. Relative and observed survival rates were assessed for temporal trends. Multinomial logistic regression investigated the relationship between American Joint Committee on Cancer (AJCC) stage and increasing calendar year.

Results

No significant improvement in 2- or 5-year observed survival (OS) or relative survival (RS) was observed. The 5-year RS ranged from 61.72 to 63.97%, and the 5-year OS ranged from 54.26 to 56.52%. With each increasing year, the proportion of stage 4 disease increased, with risk for stage 4 disease at the time of diagnosis increasing 2.2% annually (adjusted odds ratio [aOR], 1.022; 95% confidence interval [CI], 1.017–1.028; p < 0.001). This increase was driven by a 4.7% yearly increase in N2 disease (aOR, 1.047; 95% CI, 1.041–1.053; p < 0.001), with an annual 1.2% increase in T3 disease (aOR, 1.012; 95% CI, 1.007–1.018; p < 0.001) and a 1.2% increase in T4 disease (aOR, 1.012; 95% CI, 1.005–1.018; p < 0.001).

Conclusion

Despite advances in the field, laryngeal cancer survival in the United States is not improving over time. This may be due to an increase in the proportion of stage 4 disease, driven primarily by increasing nodal disease. To achieve survival improvement commensurate with scientific and technologic advances, efforts should be made to diagnose and treat laryngeal cancer at earlier stages to prevent further stage migration.

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Authors and Affiliations

  1. Department of Otolaryngology–Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Michael M. Li MD, Anuraag S. Parikh MD, Catherine T. Haring MD, Brian Swendseid MD, Kevin Y. Zhan MD, Carol R. Bradford MD, Ricardo L. Carrau MD, MBA, Kyle K. VanKoevering MD, Nolan B. Seim MD, Matthew O. Old (MD), James W. Rocco MD, PhD & Stephen Y. Kang MD

  2. Department of Biomedical Informatics and Center for Biostatistics, The Ohio State University, Columbus, OH, USA

    Songzhu Zhao MS & Guy Brock PhD

  3. Department of Otolaryngology–Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, ON, Canada

    Antoine Eskander MD, ScM

  4. College of Medicine, Ohio State University, Columbus, OH, USA

    Chandler Rygalski BS

  5. University Hospital Seidman Cancer Center, Cleveland, OH, USA

    Theodoros N. Teknos MD

  6. Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Sidharth V. Puram (MD, PhD)

  7. Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA

    Sidharth V. Puram (MD, PhD)

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  1. Michael M. Li MD
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Corresponding author

Correspondence to Stephen Y. Kang MD.

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Fig. S1

Pathologic N stage distribution. Pathologic N2 disease increased from 2004 through 2013 before decreasing from 2014 to 2016. A similar trend in N1 disease was observed, whereas N0 disease decreased from 2004 through 2015 before increasing in 2016. (TIFF 3387 kb)

Supplementary file1 (DOCX 15 kb)

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Li, M.M., Zhao, S., Eskander, A. et al. Stage Migration and Survival Trends in Laryngeal Cancer. Ann Surg Oncol 28, 7300–7309 (2021). https://doi.org/10.1245/s10434-021-10318-1

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