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Laryngoscope. 2019 Jan 10. doi: 10.1002/lary.27785. [Epub ahead of print]

Nonsquamous cell laryngeal cancers: Incidence, demographics, care patterns, and effect of surgery.

Author information

1
Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, U.S.A.
2
Yale Cancer Center, New Haven, Connecticut, U.S.A.

Abstract

OBJECTIVES:

To analyze the incidence and clinical profile of nonsquamous cell (non-SCC) laryngeal carcinomas and to analyze the effect of surgery on survival.

STUDY DESIGN:

A retrospective analysis of the National Cancer Database (2004-2014).

METHODS:

Adult patients with non-SCC laryngeal cancers were divided into six major histological subtypes. A descriptive clinical profile was obtained for non-SCC patients, and multivariate regressions were performed to analyze the effect of surgery on survival within the non-SCC cohort.

RESULTS:

We identified 878 cases of non-SCC laryngeal cancers, representing 1.02% of all malignant laryngeal cancers. Neuroendocrine tumors and bone/cartilage sarcomas made up the largest groups (37.02% and 32.35%, respectively). Metastasis (M) was higher in neuroendocrine tumors, representing 19.1% of those with known clinical M stages. Of those treated, the majority of patients with bone/cartilage sarcomas (80.9%) and minor salivary gland tumors (82.6%) received surgery as part of their treatment. Survival varied significantly based upon histology, with bone/cartilage sarcomas having the highest 5-year survival at 90.4%, and neuroendocrine tumors exhibiting the poorest 5-year survival at 25.7%. Multivariate analyses found surgery to be significantly associated with improved survival (hazard ratio: 0.679; 95% confidence interval: 0.472-0.976; P = 0.036). The specific surgical method (i.e., local excision vs. partial vs. total laryngectomy) did not have any effect on survival.

CONCLUSION:

Approximately 1% of all malignant laryngeal cancers are non-SCC in origin. At presentation, neuroendocrine tumors have the highest rate of distant metastasis and have the worst prognosis of the non-SCC cancers. Most non-SCC patients received surgery as part of their treatment regimen.

LEVEL OF EVIDENCE:

NA. Laryngoscope, 2019.

KEYWORDS:

National Cancer Database; Nonsquamous cell laryngeal cancers; head and neck cancer; laryngeal cancer

PMID:
30632157
DOI:
10.1002/lary.27785

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