Early Stage Laryngeal Cancer Patients Getting More Surgery, Late Stage Ones More Chemoradiation

Editor's Choice
Academic Journal
Main Category: Ear, Nose and Throat
Also Included In: Cancer / Oncology
Article Date: 18 Oct 2011 - 5:00 PDT


The October issue of Archives of Otolaryngology - Head & Neck Surgery, one of the JAMA/Archives journals reports that in the U.S. surgery for the treatment of early-stage laryngeal cancer (cancer of the voice box) is increasing together with the use of chemotherapy in combination with radiation therapy for treatment of patients in an advanced stage of the disease.

Background information in the articles shows that almost 13,000 people in the U.S. were diagnosed with cancer of the larynx in 2010 of which 3,660 were projected to succumb to their illness. Traditionally early-stage laryngeal cancer has involved radiation therapy or surgical resection (removal of part of the larynx) with relatively successful outcomes.

Amy Y. Chen, M.D., M.P.H. and her team at the Emory University and the American Cancer Society in Atlanta decided to assess trends and four-year survival rates of surgical and non-surgical treatment for laryngeal cancer by evaluating data of 131,694 laryngeal cancer cases that were identified from the National Cancer Database between 1985 to 2007. The data included primary treatment information, such as radiation therapy (RT), chemoradiation (CRT, chemotherapy in combination with radiation therapy) as well as intended curative surgery. Their analysis showed that over the years, surgical resection for early-stage laryngeal cancer increased whilst radiation treatments decreased correspondingly.

Their report says:

"Among patients with early-stage cancer, the proportion receiving primary surgery increased (from 20 percent in 1985 to 33 percent in 2007), whereas the use of RT decreased from 64 percent to 52 percent. The four-year survival rate for patients with early-stage laryngeal cancer treated with surgery was higher than the rate for those treated with RT (79 percent vs. 71 percent). Among patients with advanced-stage cancer, the use of CRT increased from less than 7 percent to 45 percent, whereas the use of total laryngectomy [surgical removal of the voice box] decreased from 42 percent to 32 percent."

The four-year survival rate for advanced-stage patients who underwent a total laryngectomy was 51% whilst those treated with CRT had survival rate of 48%, and those receiving RT 38% respectively.

The findings revealed that the likelihood of receiving surgery for early-stage laryngeal cancer and CRT for advanced-stage cancer was higher for those patients residing in areas with higher socioeconomic status zip codes, who had private insurance. Non-African-Americans with early stage laryngeal cancer treated at academic facilities were also more likely to receive surgery whilst younger patients with advanced-stage cancer were more commonly treated with CRT.

In a concluding statement the authors say:

"Not only were clinical factors associated with type of treatment, but select socio-demographic elements were also associated with treatment. Further investigation as to the decision-making process of patients with different socio-demographic backgrounds will assist in mitigating the differences in survival for this group of patients."

Written by Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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