Association of clinical factors with survival outcomes in laryngeal squamous cell carcinoma (LSCC)

• Published in: PloS one 2019-11, Vol.14 (11), p.e0224665
• Main Authors: Fong, Pei Yuan, Tan, Sze Huey, Lim, Darren Wan Teck, Tan, Eng Huat, Ng, Quan Sing, Sommat, Kiattisa, Tan, Daniel Shao Weng, Ang, Mei Kim
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Cancer; Cancer therapies; Carcinoma; Care and treatment; Cell survival; Chemoradiotherapy; Chemoradiotherapy, Adjuvant - statistics & numerical data; Chemotherapy; Comorbidity; Female; Head & neck cancer; Humans; Identification methods; Kaplan-Meier Estimate; Laryngeal cancer; Laryngeal Neoplasms - mortality; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - therapy; Laryngectomy - statistics & numerical data; Larynx; Larynx - pathology; Larynx - radiation effects; Larynx - surgery; Lymphatic Metastasis - pathology; Lymphatic Metastasis - therapy; Male; Medical diagnosis; Medicine and Health Sciences; Middle Aged; Neoadjuvant Therapy - statistics & numerical data; Neoplasm Staging; Oncology; Operating systems (Software); Organ Sparing Treatments - statistics & numerical data; Patient outcomes; Patients; Preservation; Prognosis; Progression-Free Survival; Radiation; Radiation (Physics); Radiation therapy; Retrospective Studies; Singapore - epidemiology; Smoking; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - mortality; Squamous Cell Carcinoma of Head and Neck - pathology; Squamous Cell Carcinoma of Head and Neck - therapy; Studies; Surgery; Surgical outcomes; Survival; Survival analysis; Tumors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0224665

Treatment strategies in laryngeal squamous cell cancer (LSCC) straddle the need for long term survival and tumor control as well as preservation of laryngeal function as far as possible. We sought to identify prognostic factors affecting LSCC outcomes in our population. Clinical characteristics, treatments and survival outcomes of patients with LSCC were analysed. Baseline comorbidity data was collected and age-adjusted Charlson Comorbidity Index (aCCI) was calculated. Outcomes of overall survival (OS), progression-free survival (PFS) and laryngectomy-free survival (LFS) were evaluated. Two hundred and fifteen patients were included, 170 (79%) underwent primary radiation/ chemoradiation and the remainder upfront surgery with adjuvant therapy where indicated. The majority of patients were male, Chinese and current/ex-smokers. Presence of comorbidity was common with median aCCI of 3. Median OS was 5.8 years. On multivariable analyses, high aCCI and advanced nodal status were associated with inferior OS (HR 1.24 per one point increase in aCCI, P