Long-term survival trend after primary total laryngectomy for patients with locally advanced laryngeal carcinoma

Lin, Zhongyang; Lin, Hanqing; Chen, Yuqing; Xu, Yuanteng; Chen, Xihang; Fan, Hui; Wu, Xiaobo; Ke, Xiaoying; Lin, Chang

doi:10.7150/jca.50404

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J Cancer 2021; 12(4):1220-1230. doi:10.7150/jca.50404 This issue Cite

Research Paper

Long-term survival trend after primary total laryngectomy for patients with locally advanced laryngeal carcinoma

Zhongyang Lin, M.D.¹, Hanqing Lin, M.D.², Yuqing Chen, M.D.¹, Yuanteng Xu, M.D., Ph.D.¹, Xihang Chen, M.D.¹, Hui Fan, M.D, Ph.D.¹, Xiaobo Wu, M.D.¹, Xiaoying Ke, M.D.¹, Chang Lin, M.D., Ph.D^1✉

1. Department of Otolaryngology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
2. Department of Otolaryngology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.

Citation:

Lin Z, Lin H, Chen Y, Xu Y, Chen X, Fan H, Wu X, Ke X, Lin C. Long-term survival trend after primary total laryngectomy for patients with locally advanced laryngeal carcinoma. J Cancer 2021; 12(4):1220-1230. doi:10.7150/jca.50404. https://www.jcancer.org/v12p1220.htm

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Abstract

Purpose: To evaluate long-term survival trends after primary total laryngectomy (TL) for locally advanced laryngeal carcinoma (LC).

Methods: A total of 2094 patients diagnosed with locally advanced LC and underwent primary TL (1992-2011, at least 5-year follow-up) in the Surveillance, Epidemiology, and End Results (SEER) database were included in this study. Besides the traditional overall survival (OS) and cancer-specific survival (CSS) by using Kaplan-Meier curves, the 3-year conditional survival analysis was also performed to describe the long-term trends in these patients. Time-dependent multivariate competing-risk models were constructed to assess the persistent sub-distribution hazard of prognostic factors. Finally, a nomogram was developed to predict conditional cancer-specific survival.

Results: The curves of overall hazard and cancer-specific hazard both quickly reached the apex within the first year since TL, then decreased thereafter. In general, the CS3 steadily increased from within 5 years after TL. In the stratified CS3 analysis, the increments in patients with adverse characteristics were more pronounced. 4 years after TL, the probability of surviving the next year exceeded 90%. The time-dependent multivariate competing-risk models indicated that age and lymph node ratio (LNR) persistently contributed to the cancer-specific outcome. The nomogram based on the competing-risk model was constructed to estimate CSS probability conditional upon 3 years for advanced LC patients having survived 1, 2, and 3 years.

Conclusion: Most patients achieved a substantially improved survival rate after surviving a long period after primary TL. Patients diagnosed at older age and with higher LNR should receive more effective follow-up. The predictive nomogram can provide significant evidence for clinical research and practice.

Keywords: laryngeal carcinoma, locally advanced, laryngectomy, conditional survival, SEER database

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APA

Lin, Z., Lin, H., Chen, Y., Xu, Y., Chen, X., Fan, H., Wu, X., Ke, X., Lin, C. (2021). Long-term survival trend after primary total laryngectomy for patients with locally advanced laryngeal carcinoma. Journal of Cancer, 12(4), 1220-1230. https://doi.org/10.7150/jca.50404.

ACS

Lin, Z.; Lin, H.; Chen, Y.; Xu, Y.; Chen, X.; Fan, H.; Wu, X.; Ke, X.; Lin, C. Long-term survival trend after primary total laryngectomy for patients with locally advanced laryngeal carcinoma. J. Cancer 2021, 12 (4), 1220-1230. DOI: 10.7150/jca.50404.

NLM

CSE

Lin Z, Lin H, Chen Y, Xu Y, Chen X, Fan H, Wu X, Ke X, Lin C. 2021. Long-term survival trend after primary total laryngectomy for patients with locally advanced laryngeal carcinoma. J Cancer. 12(4):1220-1230.

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