PMID- 28708883
OWN - NLM
STAT- MEDLINE
DCOM- 20170926
LR  - 20190221
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 7
DP  - 2017
TI  - Impact of stage, management and recurrence on survival rates in laryngeal cancer.
PG  - e0179371
LID - 10.1371/journal.pone.0179371 [doi]
LID - e0179371
AB  - A retrospective, longitudinal study of 1,616 patients with primary laryngeal 
      squamous cell carcinoma (LSCC) at a single center in Norway during 1983-2010 was 
      undertaken to investigate overall survival, disease specific survival, 
      disease-free survival, prognostic factors for overall survival, and impact of 
      recurrence among all-stage laryngeal cancer patients over 15 years' follow-up. 
      The prognostic impact of gender, age, smoking/alcohol, subsite, tumour, node and 
      metastasis staging, period and modality of treatment were evaluated using 
      Kaplan-Meier and Cox proportional hazard analyses. The importance of recurrence 
      on survival was assessed based on case fatality rates. Five-year overall survival 
      was 56.8%, 64.0% and 38.8%, and disease-specific survival was 80.2%, 87% and 
      61.6%, respectively, for the entire cohort and for glottic and supraglottic LSCC. 
      Old age, advanced-stage LSCC and supraglottic cancer were associated with lower 
      overall survival. The risk of disease-specific death plateaued after five years 
      and varied significantly by subsite. Multivariate analysis of glottic LSCC 
      revealed that surgical treatment improved overall survival, whereas old age, 
      alcohol, T3-T4 status, positive N-status and no treatment were associated with 
      worse survival. In supraglottic LSCC, age, alcohol, and positive N-status had a 
      significant impact on overall survival by multivariate analysis. Five-year 
      overall survival and disease-specific survival among patients with recurrent 
      disease were 34% and 52%, respectively. In conclusion, marked difference in 
      overall survival between glottic and supraglottic LSCC underline the importance 
      of subsite-specific survival analysis. T-status and primary surgical management 
      is essential only for glottic LSCC, emphasizing the importance of correct disease 
      classification. Inferior outcomes in supraglottic LSCC are associated with old 
      age, positive N-status, and improved follow-up routines are necessary. Primary 
      tumor control is essential since recurrence impairs survival considerably in all 
      subsites. The potential benefit of a primary surgical approach towards T3 LSCC 
      awaits further investigation.
FAU - Brandstorp-Boesen, Jesper
AU  - Brandstorp-Boesen J
AUID- ORCID: 0000-0003-2709-9912
AD  - University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, 
      Norway.
AD  - Department of Otorhinolaryngology, Division of Surgery and Clinical Neuroscience, 
      Oslo University Hospital, Oslo, Norway.
FAU - Sorum Falk, Ragnhild
AU  - Sorum Falk R
AD  - Oslo Centre for Biostatistics and Epidemiology, Research Support Service, Oslo 
      University Hospital, Oslo, Norway.
FAU - Boysen, Morten
AU  - Boysen M
AD  - University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, 
      Norway.
AD  - Department of Otorhinolaryngology, Division of Surgery and Clinical Neuroscience, 
      Oslo University Hospital, Oslo, Norway.
FAU - Brondbo, Kjell
AU  - Brondbo K
AD  - University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, 
      Norway.
AD  - Department of Otorhinolaryngology, Division of Surgery and Clinical Neuroscience, 
      Oslo University Hospital, Oslo, Norway.
LA  - eng
PT  - Journal Article
DEP - 20170714
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Aged
MH  - Alcohol Drinking
MH  - Carcinoma, Squamous Cell/mortality/*pathology
MH  - Disease-Free Survival
MH  - Female
MH  - Glottis/pathology
MH  - Head and Neck Neoplasms/mortality/*pathology
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Laryngeal Neoplasms/mortality/*pathology
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Smoking
MH  - Squamous Cell Carcinoma of Head and Neck
PMC - PMC5510803
COIS- Competing Interests: The authors have no conflicts of interest to declare.
EDAT- 2017/07/15 06:00
MHDA- 2017/09/28 06:00
PMCR- 2017/07/14
CRDT- 2017/07/15 06:00
PHST- 2017/03/14 00:00 [received]
PHST- 2017/05/30 00:00 [accepted]
PHST- 2017/07/15 06:00 [entrez]
PHST- 2017/07/15 06:00 [pubmed]
PHST- 2017/09/28 06:00 [medline]
PHST- 2017/07/14 00:00 [pmc-release]
AID - PONE-D-17-10092 [pii]
AID - 10.1371/journal.pone.0179371 [doi]
PST - epublish
SO  - PLoS One. 2017 Jul 14;12(7):e0179371. doi: 10.1371/journal.pone.0179371. 
      eCollection 2017.